Provider Demographics
NPI:1205849858
Name:DOTSON, ANTON ROBERT (MD)
Entity Type:Individual
Prefix:
First Name:ANTON
Middle Name:ROBERT
Last Name:DOTSON
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 1:145 MISSION RANCH BLVD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-2175
Mailing Address - Country:US
Mailing Address - Phone:530-896-2200
Mailing Address - Fax:530-896-2209
Practice Address - Street 1:145 MISSION RANCH BLVD
Practice Address - Street 2:SUITE 110
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-2175
Practice Address - Country:US
Practice Address - Phone:530-896-2200
Practice Address - Fax:530-896-2209
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV8888207K00000X
CAG69131207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
No207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1235301805Medicaid
00G691312Medicare PIN
00G691311Medicare PIN
F51365Medicare UPIN