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NPI Code Detail

MEDICARE: MUDIT DABRAL, M.D.

MEDICARE: MUDIT DABRAL, 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
1207RP1001XPulmonary Disease PhysicianA40705CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1ZZZ09774ZOTHERCABLUE SHIELD OF CA GRP #
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1447320569
Entity Type Code : Organization
Provider Name (Legal Business Name) : MUDIT DABRAL, M.D.
Provider Business Mailing Address
First Line : 1505 SHEPARD DR
Second Line : SUITE 105
City : SANTA MARIA
State : CA
Zip : 93454-7020
Country : US
Telephone Number : 805-928-9770
Fax Number : 805-928-6350
Provider Business Practice Location Address
First Line : 1505 SHEPARD DR
Second Line : SUITE 105
City : SANTA MARIA
State : CA
Zip : 93454-7020
Country : US
Telephone Number : 805-928-9770
Fax Number : 805-928-6350
Authorized Official
Title or Position : OWNER
Name : DR. MUDIT DABRAL
Credential : M.D.
Telephone Number : 805-928-9770
Provider Enumeration Date : 11/08/2006
Last Update Date : 04/20/2008

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