Provider Demographics
NPI:1477751709
Name:DUNN, DAVID (NONE) (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:(NONE)
Last Name:DUNN
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:PO BOX 1184
Mailing Address - Street 2:
Mailing Address - City:BLYTHE
Mailing Address - State:CA
Mailing Address - Zip Code:92226-1184
Mailing Address - Country:US
Mailing Address - Phone:760-922-6359
Mailing Address - Fax:
Practice Address - Street 1:19025 WILEYS WELL RD
Practice Address - Street 2:
Practice Address - City:BLYTHE
Practice Address - State:CA
Practice Address - Zip Code:92225-2287
Practice Address - Country:US
Practice Address - Phone:760-922-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-09
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC33848207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
A35402Medicare UPIN