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NPI Code Detail

MEDICARE: CHRISTINE DAHLE ATC

MEDICARE:   CHRISTINE  DAHLE  ATC
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
12255A2300XAthletic Trainer

General Provider Information

NPI Number : 1346787272
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINE DAHLE ATC
Provider Business Mailing Address
First Line : 1202 W EDINGER AVE
Second Line :
City : SANTA ANA
State : CA
Zip : 92707-2126
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1202 W EDINGER AVE
Second Line :
City : SANTA ANA
State : CA
Zip : 92707-2126
Country : US
Telephone Number : 714-754-7711
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2017
Last Update Date : 01/30/2017

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Directions to “ CHRISTINE DAHLE ATC” Practice Location

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