Provider Demographics
NPI:1245215870
Name:DUNITZ, NEAL ALLAN (MD)
Entity Type:Individual
Prefix:DR
First Name:NEAL
Middle Name:ALLAN
Last Name:DUNITZ
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 1:2401 E ORANGEBURG AVE STE 330
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95355-3396
Mailing Address - Country:US
Mailing Address - Phone:209-724-6000
Mailing Address - Fax:209-724-6000
Practice Address - Street 1:2401 E ORANGEBURG AVE
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95355-3351
Practice Address - Country:US
Practice Address - Phone:209-724-6000
Practice Address - Fax:209-724-6034
Is Sole Proprietor?:No
Enumeration Date:2005-12-06
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD19131207R00000X
CAG49187207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR068564Medicaid
OR288287OtherOMAP BILLING NUMBER
WA8212961OtherWASHINGTON MAP NUMBER
OR288287OtherOMAP BILLING NUMBER
OR068564Medicaid
OR105934Medicare PIN