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General NPI Number Information
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NPI Number | 1962583435
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Entity Type | Organization
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Legal Business Name | HARRY DASSAH INC
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Dates
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Enumeration Date | 10/18/2006
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Last Update Date | 08/13/2013
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Provider Practice Location Address
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Address Line | 405 BOYD ST 830 UNION AVE. FAIRFIELD CA 94533- SECOND LOCATION
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City | VACAVILLE
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State | CA
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Zip | 95688-4521
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Country | US
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Telephone | 707-449-0483
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Fax | 707-448-0443
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Provider Business Mailing Address
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Address Line | 405 BOYD ST 830 UNION AVE. FAIRFIELD
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City | VACAVILLE
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State | CA
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Zip | 95688-4521
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Country | US
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Telephone | 707-449-0483
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Fax | 707-448-0443
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Authorized Official
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Title or Position | PRESIDENT
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Name | HARRY DASSAH
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Credential | M.D.
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Telephone | 707-449-0483
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | A385030
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License Number State | CA
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