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NPI Code Detail

MEDICARE: SEAN-MIKAEL DODENHOFF MD

MEDICARE: SEAN-MIKAEL DODENHOFF MD
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
1207Q00000XFamily Medicine PhysicianA193220CA

General Provider Information

NPI Number : 1508430125
Entity Type Code : Individual
Provider Name (Legal Business Name) : SEAN-MIKAEL DODENHOFF MD
Provider Business Mailing Address
First Line : 11634 FAIR OAKS BLVD
Second Line :
City : FAIR OAKS
State : CA
Zip : 95628-3771
Country : US
Telephone Number : 916-983-8868
Fax Number :
Provider Business Practice Location Address
First Line : 11634 FAIR OAKS BLVD
Second Line :
City : FAIR OAKS
State : CA
Zip : 95628-3771
Country : US
Telephone Number : 916-983-8868
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2021
Last Update Date : 07/11/2024

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Directions to “ SEAN-MIKAEL DODENHOFF MD” Practice Location

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