MEDICARE: DR. DOUGLAS DEAN DENGERINK D.O.

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	207QS0010X	Sports Medicine (Family Medicine) Physician	20A9206	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	GL046Z	OTHER	CA	MEDICARE PTAN

General Provider Information

NPI Number	:	1598761413
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DOUGLAS DEAN DENGERINK D.O.

Provider Business Mailing Address
First Line	:	6699 ALVARADO RD
Second Line	:	SUITE 2100
City	:	SAN DIEGO
State	:	CA
Zip	:	92120-5244
Country	:	US
Telephone Number	:	619-229-3909
Fax Number	:	619-229-3902

Provider Business Practice Location Address
First Line	:	6699 ALVARADO RD
Second Line	:	SUITE 2100
City	:	SAN DIEGO
State	:	CA
Zip	:	92120-5244
Country	:	US
Telephone Number	:	619-229-3909
Fax Number	:	619-229-3902

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2005
Last Update Date	:	09/13/2012

Similar Medicare Providers

1881914000 — GRUPO MEDICO POLICLINICA SAN PEDRO MEDICARE ADVANTAGE
Practice Location Address:

211 CALLE MORSE
ARROYO, PR
00714-2350

Practice Phone: 787-839-3980
Practice Fax: 787-271-2515

1356449425 — DR. TREVOR HOWARD HENDERSON MD
Practice Location Address:

6699 ALVARADO RD , SUITE 2200
SAN DIEGO, CA
92120-5244

Practice Phone: 619-265-3400
Practice Fax: 619-265-3407

1952496291 — OLEG M GAVRILYUK M.D.
Practice Location Address:

6699 ALVARADO RD , STE. 2302
SAN DIEGO, CA
92120-5244

Practice Phone: 619-578-2518
Practice Fax: 619-501-6498

1619004421 — PULMONARY MEDICINE & INFECTIOUS DISEASE MEDICAL GROUP
Practice Location Address:

6699 ALVARADO RD , SUITE 2308
SAN DIEGO, CA
92120-5244

Practice Phone: 619-462-9010
Practice Fax: 619-287-8165

1124220181 — SAN DIEGO INSTITUTE OF GASTROENTEROLOGY AND NUTRITION
Practice Location Address:

6699 ALVARADO RD , SUITE 2301
SAN DIEGO, CA
92120-5244

Practice Phone: 619-229-1005
Practice Fax: 619-326-0380

1679764179 — DR. MELISSA KAGNOFF M.D.
Practice Location Address:

6699 ALVARADO RD , SUITE 2301
SAN DIEGO, CA
92120-5244

Practice Phone: 619-582-2595
Practice Fax: 619-229-8006

Directions to “ DR. DOUGLAS DEAN DENGERINK D.O.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.