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NPI Code Detail

MEDICARE: DUNECREST MEDICAL GROUP

MEDICARE: DUNECREST MEDICAL GROUP
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 PhysicianA60458CA

General Provider Information

NPI Number : 1710131370
Entity Type Code : Organization
Provider Name (Legal Business Name) : DUNECREST MEDICAL GROUP
Provider Business Mailing Address
First Line : 232 RESERVATION RD
Second Line :
City : MARINA
State : CA
Zip : 93933-3083
Country : US
Telephone Number : 831-384-0662
Fax Number : 831-384-0754
Provider Business Practice Location Address
First Line : 232 RESERVATION RD
Second Line :
City : MARINA
State : CA
Zip : 93933-3083
Country : US
Telephone Number : 831-384-0662
Fax Number : 831-384-0754
Authorized Official
Title or Position : PRESIDENT/ OWNER
Name : DR. DEBORAH BROWN
Credential : MD
Telephone Number : 831-384-0662
Provider Enumeration Date : 11/10/2008
Last Update Date : 06/17/2019

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