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NPI Code Detail

MEDICARE: DR. ERIC JAY DOLGIN D.O.

MEDICARE: DR. ERIC JAY DOLGIN D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1204D00000XNeuromusculoskeletal Medicine & OMM PhysicianC3731601CA

General Provider Information

NPI Number : 1033232483
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ERIC JAY DOLGIN D.O.
Provider Business Mailing Address
First Line : 2128 PICO BLVD
Second Line :
City : SANTA MONICA
State : CA
Zip : 90405-1718
Country : US
Telephone Number : 310-664-8818
Fax Number : 310-664-8878
Provider Business Practice Location Address
First Line : 2128 PICO BLVD
Second Line :
City : SANTA MONICA
State : CA
Zip : 90405-1718
Country : US
Telephone Number : 310-664-8818
Fax Number : 310-664-8878
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2007
Last Update Date : 07/08/2007

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