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NPI Code Detail

MEDICARE: MS. DIANNE MARIE DAWES P.A.-C

MEDICARE: MS. DIANNE MARIE DAWES P.A.-C
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
1363AM0700XMedical Physician AssistantPA14568CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1PA14568OTHERCAPA LICENSE

General Provider Information

NPI Number : 1154459774
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DIANNE MARIE DAWES P.A.-C
Provider Business Mailing Address
First Line : 2342 PROFESSIONAL PKWY
Second Line : SUITE 310
City : SANTA MARIA
State : CA
Zip : 93455-1629
Country : US
Telephone Number : 805-934-2488
Fax Number :
Provider Business Practice Location Address
First Line : 2342 PROFESSIONAL PKWY
Second Line : SUITE 310
City : SANTA MARIA
State : CA
Zip : 93455-1629
Country : US
Telephone Number : 805-934-2488
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/02/2007
Last Update Date : 07/08/2007

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