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NPI Code Detail

MEDICARE: MICHAEL RONALL DUNN

MEDICARE: MICHAEL RONALL DUNN
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
1101YA0400XAddiction (Substance Use Disorder) Counselor
2172V00000XCommunity Health Worker

General Provider Information

NPI Number : 1346419819
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL RONALL DUNN
Provider Business Mailing Address
First Line : 300 HARBOR BLVD BLDG E
Second Line :
City : BELMONT
State : CA
Zip : 94002-4018
Country : US
Telephone Number : 650-817-9070
Fax Number : 650-817-9074
Provider Business Practice Location Address
First Line : 505 CYPRESS AVE
Second Line :
City : SOUTH SAN FRANCISCO
State : CA
Zip : 94080-2922
Country : US
Telephone Number : 650-380-6149
Fax Number : 650-817-9074
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/28/2008
Last Update Date : 07/11/2024

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