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NPI Code Detail

MEDICARE: DANIELLE B. DOREY PA

MEDICARE: DANIELLE B. DOREY PA
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
1363A00000XPhysician AssistantPA51652CA
2363AS0400XSurgical Physician AssistantPA.0008159CO
3363AS0400XSurgical Physician AssistantPA51652CA

General Provider Information

NPI Number : 1578966925
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIELLE B. DOREY PA
Provider Business Mailing Address
First Line : 3020 CHILDRENS WAY # MC5003
Second Line :
City : SAN DIEGO
State : CA
Zip : 92123-4223
Country : US
Telephone Number : 858-309-6300
Fax Number :
Provider Business Practice Location Address
First Line : 7920 FROST ST STE 200
Second Line :
City : SAN DIEGO
State : CA
Zip : 92123-4289
Country : US
Telephone Number : 858-966-4013
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/30/2014
Last Update Date : 08/07/2025

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