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General NPI Number Information
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NPI Number | 1801642566
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Entity Type | Organization
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Legal Business Name | DGC MEDICAL INC
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Dates
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Enumeration Date | 04/24/2024
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Last Update Date | 04/24/2024
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Provider Practice Location Address
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Address Line | 222 S MAIN ST APT 1610
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City | LOS ANGELES
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State | CA
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Zip | 90012-4584
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Country | US
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Telephone | 213-433-5632
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Fax |
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Provider Business Mailing Address
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Address Line | 222 S MAIN ST APT 1610
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City | LOS ANGELES
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State | CA
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Zip | 90012-4584
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DENNIS CHANG
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Credential | DO
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Telephone | 213-433-5632
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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