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General NPI Number Information
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NPI Number | 1699974634
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Entity Type | Individual
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Provider Name | CARMINA RAMOS DIZON MD
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Gender | Female
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Dates
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Enumeration Date | 07/11/2007
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Last Update Date | 01/11/2022
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Provider Practice Location Address
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Address Line | 815 DR MARTIN LUTHER KING JR BLVD
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City | BAKERSFIELD
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State | CA
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Zip | 93307-1365
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Country | US
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Telephone | 661-322-3905
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Fax | 661-322-1370
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Provider Business Mailing Address
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Address Line | 39400 PASEO PADRE PKWY
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City | FREMONT
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State | CA
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Zip | 94538-2310
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Country | US
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Telephone | 661-635-3050
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Fax | 661-869-1503
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A100108
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License Number State | CA
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