Provider Demographics
NPI:1245434190
Name:MOTAS, DOMINIKA (MD)
Entity type:Individual
Prefix:
First Name:DOMINIKA
Middle Name:
Last Name:MOTAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 45731
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94145-0731
Mailing Address - Country:US
Mailing Address - Phone:858-244-0115
Mailing Address - Fax:858-244-0153
Practice Address - Street 1:747 52ND ST
Practice Address - Street 2:DEPT. OF ANESTHESIOLOGY
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-1809
Practice Address - Country:US
Practice Address - Phone:510-428-3070
Practice Address - Fax:510-450-5833
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA86076207LP3000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP3000XAllopathic & Osteopathic PhysiciansAnesthesiologyPediatric Anesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A860760Medicaid
CA00A860760Medicaid