MEDICARE: DALIA DAWOUD MD INC

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	261QU0200X	Urgent Care Clinic/Center

General Provider Information

NPI Number	:	1437867900
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DALIA DAWOUD MD INC

Provider Business Mailing Address
First Line	:	PO BOX 10417
Second Line	:
City	:	HOLYOKE
State	:	MA
Zip	:	01041-2017
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4200 CHINO HILLS PKWY STE 800
Second Line	:
City	:	CHINO HILLS
State	:	CA
Zip	:	91709-3785
Country	:	US
Telephone Number	:	909-606-6559
Fax Number	:

Authorized Official
Title or Position	:	CENTER DIRECTOR
Name	:	SOHYUN LIM
Credential	:
Telephone Number	:	310-415-4628

Provider Enumeration Date	:	11/14/2022
Last Update Date	:	03/14/2023

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