Provider Demographics
NPI:1659670057
Name:NILOUFER S. DENNIS MD MEDICAL CORP
Entity Type:Organization
Organization Name:NILOUFER S. DENNIS MD MEDICAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NILOUFER
Authorized Official - Middle Name:S
Authorized Official - Last Name:DENNIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:800-395-9431
Mailing Address - Street 1:7930 FROST ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-2737
Mailing Address - Country:US
Mailing Address - Phone:800-395-9431
Mailing Address - Fax:888-502-8290
Practice Address - Street 1:7930 FROST ST
Practice Address - Street 2:SUITE 103
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-2737
Practice Address - Country:US
Practice Address - Phone:800-395-9431
Practice Address - Fax:888-502-8290
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-24
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA101524207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty