Provider Demographics
NPI:1639112386
Name:DUNTON, MARIA J (DO)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:J
Last Name:DUNTON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:PO BOX 12209
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92423-2209
Mailing Address - Country:US
Mailing Address - Phone:909-335-4188
Mailing Address - Fax:
Practice Address - Street 1:554 E FOOTHILL BLVD
Practice Address - Street 2:STE 103
Practice Address - City:SAN DIMAS
Practice Address - State:CA
Practice Address - Zip Code:91773-1222
Practice Address - Country:US
Practice Address - Phone:909-482-4700
Practice Address - Fax:909-482-4720
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-13
Last Update Date:2017-11-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA20A7414207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA20A7414OtherMEDICARE PTAN