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NPI Code Detail

MEDICARE: DR. DAVID P. DIMMOCK M.D.

MEDICARE: DR. DAVID P. DIMMOCK 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
1207SG0201XClinical Genetics (M.D.) PhysicianC146669CA
2208000000XPediatrics PhysicianC146669CA
3207SG0202XClinical Biochemical Genetics PhysicianC146669CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1275796419
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVID P. DIMMOCK M.D.
Provider Business Mailing Address
First Line : 3030 CHILDRENS WAY
Second Line :
City : SAN DIEGO
State : CA
Zip : 92123-4232
Country : US
Telephone Number : 800-788-9029
Fax Number : 858-966-8092
Provider Business Practice Location Address
First Line : 3030 CHILDRENS WAY
Second Line :
City : SAN DIEGO
State : CA
Zip : 92123-4232
Country : US
Telephone Number : 800-788-9029
Fax Number : 858-966-8092
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2008
Last Update Date : 07/14/2022

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