Provider Demographics
NPI:1407880693
Name:GROTEN, DAWN M (MD)
Entity Type:Individual
Prefix:DR
First Name:DAWN
Middle Name:M
Last Name:GROTEN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:3212 JEFFERSON ST # 196
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-3436
Mailing Address - Country:US
Mailing Address - Phone:707-255-8825
Mailing Address - Fax:707-252-9325
Practice Address - Street 1:1510 4TH ST
Practice Address - Street 2:SUITE 1
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94710-1717
Practice Address - Country:US
Practice Address - Phone:510-525-8980
Practice Address - Fax:510-525-8982
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2014-06-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG54516207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G545161Medicaid
CACH463ZMedicare PIN