MEDICARE: DR. WARREN I DOTZ M.D.

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
1	207N00000X	Dermatology Physician	G52256	CA

General Provider Information

NPI Number	:	1073546479
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WARREN I DOTZ M.D.

Provider Business Mailing Address
First Line	:	2999 REGENT ST
Second Line	:	SUITE 300
City	:	BERKELEY
State	:	CA
Zip	:	94705-2146
Country	:	US
Telephone Number	:	510-540-5010
Fax Number	:	510-540-0325

Provider Business Practice Location Address
First Line	:	2999 REGENT ST
Second Line	:	SUITE 300
City	:	BERKELEY
State	:	CA
Zip	:	94705-2146
Country	:	US
Telephone Number	:	510-540-5010
Fax Number	:	510-540-0325

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/09/2006
Last Update Date	:	07/09/2007

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