Provider Demographics
NPI:1780472506
Name:BETH A. DORN, MD, INC.
Entity type:Organization
Organization Name:BETH A. DORN, MD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:BETH
Authorized Official - Middle Name:A
Authorized Official - Last Name:DORN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-375-2288
Mailing Address - Street 1:3010 BEARD RD
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-3442
Mailing Address - Country:US
Mailing Address - Phone:707-255-8825
Mailing Address - Fax:707-252-9325
Practice Address - Street 1:3701 SKYPARK DR STE 150
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-4775
Practice Address - Country:US
Practice Address - Phone:310-375-2288
Practice Address - Fax:310-791-7974
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-30
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty