Provider Demographics
NPI:1851593065
Name:DAWOOD, RONNIE NATHAN (MD)
Entity Type:Individual
Prefix:MR
First Name:RONNIE
Middle Name:NATHAN
Last Name:DAWOOD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:255 TERRACINA BLVD
Mailing Address - Street 2:STE 206
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-4870
Mailing Address - Country:US
Mailing Address - Phone:949-367-1115
Mailing Address - Fax:888-561-4883
Practice Address - Street 1:26342 OSO PKWY
Practice Address - Street 2:SUITE 204
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-5645
Practice Address - Country:US
Practice Address - Phone:949-367-1115
Practice Address - Fax:888-561-4883
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-01
Last Update Date:2020-09-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA100261207ND0101X, 207NS0135X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic SurgeryGroup - Multi-Specialty
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural DermatologyGroup - Multi-Specialty