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General NPI Number Information
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NPI Number | 1982874715
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Entity Type | Organization
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Legal Business Name | W DODSON CREIGHTON M D INC
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Dates
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Enumeration Date | 03/07/2008
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Last Update Date | 11/04/2008
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Provider Practice Location Address
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Address Line | 197 W LEGION RD SUITE #200
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City | BRAWLEY
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State | CA
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Zip | 92227-7727
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Country | US
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Telephone | 760-344-7412
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Fax | 760-344-9956
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Provider Business Mailing Address
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Address Line | 197 W LEGION RD SUITE # 200
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City | BRAWLEY
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State | CA
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Zip | 92227-7727
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Country | US
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Telephone | 760-344-7412
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Fax | 760-344-9956
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Authorized Official
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Title or Position | ALLERGY SPECIALISTS
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Name | DR. WILLIAM DODSON CREIGHTON
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Credential | M.D.
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Telephone | 760-344-7412
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | G27744
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License Number State | CA
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