Provider Demographics
NPI:1003995499
Name:HAYES, DAWN M (MD)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:M
Last Name:HAYES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4948 SAN JUAN AVE
Mailing Address - Street 2:
Mailing Address - City:FAIR OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:95628-4606
Mailing Address - Country:US
Mailing Address - Phone:916-966-6287
Mailing Address - Fax:
Practice Address - Street 1:4948 SAN JUAN AVE
Practice Address - Street 2:
Practice Address - City:FAIR OAKS
Practice Address - State:CA
Practice Address - Zip Code:95628-4606
Practice Address - Country:US
Practice Address - Phone:916-966-6287
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-04
Last Update Date:2011-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG700382083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1454404OtherUNITED HEALTHCARE
CA4287255OtherAETNA
CA024239OtherHEALTH NET
CA6543040OtherCIGNA
CA90088097OtherPACIFICARE
CAMCMG169700OtherWESTERN HEALTH ADVANTAGE
CA000810342965OtherPHCS
CAG70038OtherBLUE CROSS
CA00G700380OtherBLUE SHIELD
CA44380OtherINTERPLAN
CA00G700380Medicaid
CA629466OtherFIRST HEALTH
CA1089807OtherGREAT WEST
CA00G700380Medicare ID - Type Unspecified
CA90088097OtherPACIFICARE
CA629466OtherFIRST HEALTH