Provider Demographics
NPI:1275579278
Name:ATWAL, DAWN PARVEEN (MD)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:PARVEEN
Last Name:ATWAL
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 1:31852 COAST HWY STE 410
Mailing Address - Street 2:
Mailing Address - City:LAGUNA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92651-6767
Mailing Address - Country:US
Mailing Address - Phone:949-516-2020
Mailing Address - Fax:866-729-9762
Practice Address - Street 1:31852 COAST HWY STE 410
Practice Address - Street 2:
Practice Address - City:LAGUNA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92651-6767
Practice Address - Country:US
Practice Address - Phone:949-516-2020
Practice Address - Fax:949-516-2008
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-20
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG73846207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1528110186OtherNPI-DAWN ATWAL MD INC
CAHG73846Medicare ID - Type Unspecified
CAG26207Medicare UPIN