Provider Demographics
NPI:1518151661
Name:DAHM, JERRY MILTON (R EEG T)
Entity Type:Individual
Prefix:
First Name:JERRY
Middle Name:MILTON
Last Name:DAHM
Suffix:
Gender:M
Credentials:R EEG T
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Mailing Address - Street 1:1141 N LOOP 1064 E
Mailing Address - Street 2:#105-612
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-1339
Mailing Address - Country:US
Mailing Address - Phone:210-598-2800
Mailing Address - Fax:210-598-4236
Practice Address - Street 1:11121 SUN CENTER DR
Practice Address - Street 2:SUITE G
Practice Address - City:RANCHO CORDOVA
Practice Address - State:CA
Practice Address - Zip Code:95670-6161
Practice Address - Country:US
Practice Address - Phone:916-631-0112
Practice Address - Fax:916-631-1652
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-31
Last Update Date:2018-04-27
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic
No2472E0500XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherEEG