Provider Demographics
NPI:1235301805
Name:ANTON DOTSON MD INC
Entity Type:Organization
Organization Name:ANTON DOTSON MD INC
Other - Org Name:ALLERGY ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANTON
Authorized Official - Middle Name:
Authorized Official - Last Name:DOTSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:530-896-2200
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-24
Last Update Date:2009-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV8888207K00000X
CAG69131207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Multi-Specialty
No207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1235301805Medicaid
CA1235301805Medicaid