Provider Demographics
NPI:1134174576
Name:DUBROW, TERRY JOEL (MD)
Entity type:Individual
Prefix:
First Name:TERRY
Middle Name:JOEL
Last Name:DUBROW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:1617 WESTCLIFF DR
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-5525
Mailing Address - Country:US
Mailing Address - Phone:949-515-4111
Mailing Address - Fax:949-515-0318
Practice Address - Street 1:1617 WESTCLIFF DR
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-5524
Practice Address - Country:US
Practice Address - Phone:949-515-4111
Practice Address - Fax:949-515-0318
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-24
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG62109208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery