Provider Demographics
NPI:1841761269
Name:NS DENNIS MD MEDICAL CORPORATION
Entity Type:Organization
Organization Name:NS DENNIS MD MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NILOUFER
Authorized Official - Middle Name:
Authorized Official - Last Name:DENNIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:858-220-5199
Mailing Address - Street 1:2717 RIDGEGATE ROW
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-0915
Mailing Address - Country:US
Mailing Address - Phone:858-220-5199
Mailing Address - Fax:888-588-4410
Practice Address - Street 1:330 S MAGNOLIA AVE STE 301
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-5224
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:2018-12-11
Last Update Date:2018-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty