Provider Demographics
NPI:1346213329
Name:DOBECKI, DOUGLAS ARTHUR JR (MD)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:ARTHUR
Last Name:DOBECKI
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:DOUGLAS
Other - Middle Name:
Other - Last Name:DOBECKI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD INC
Mailing Address - Street 1:7625 MESA COLLEGE DR
Mailing Address - Street 2:SUITE 315A
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-5343
Mailing Address - Country:US
Mailing Address - Phone:858-576-1011
Mailing Address - Fax:858-576-1025
Practice Address - Street 1:7625 MESA COLLEGE DR
Practice Address - Street 2:SUITE 315A
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-5343
Practice Address - Country:US
Practice Address - Phone:858-576-1011
Practice Address - Fax:858-576-1025
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2016-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA81761207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A817610Medicaid
CA00A817610Medicaid
CAWA81761DMedicare PIN
CAA81761Medicare PIN