Provider Demographics
NPI:1740277235
Name:DIXON, STEVEN W (MD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:W
Last Name:DIXON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3165 BROAD ST
Mailing Address - Street 2:STE 112
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-6778
Mailing Address - Country:US
Mailing Address - Phone:805-545-7881
Mailing Address - Fax:805-548-8785
Practice Address - Street 1:1111 E OCEAN AVE
Practice Address - Street 2:STE 7
Practice Address - City:LOMPOC
Practice Address - State:CA
Practice Address - Zip Code:93436-7076
Practice Address - Country:US
Practice Address - Phone:805-735-3468
Practice Address - Fax:805-735-6461
Is Sole Proprietor?:No
Enumeration Date:2005-09-30
Last Update Date:2015-02-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAC041146207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAC041146Medicare ID - Type Unspecified
A37536Medicare UPIN