Provider Demographics
NPI:1073546479
Name:DOTZ, WARREN I (MD)
Entity Type:Individual
Prefix:DR
First Name:WARREN
Middle Name:I
Last Name:DOTZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2999 REGENT ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94705-2146
Mailing Address - Country:US
Mailing Address - Phone:510-540-5010
Mailing Address - Fax:510-540-0325
Practice Address - Street 1:2999 REGENT ST
Practice Address - Street 2:SUITE 300
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705-2146
Practice Address - Country:US
Practice Address - Phone:510-540-5010
Practice Address - Fax:510-540-0325
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-09
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG52256207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G522560Medicare ID - Type UnspecifiedMEDICARE IDENTIFICATION N
CAA52214Medicare UPIN