Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | G79522 | CA |
NPI | 1003994591 |
---|---|
Provider Name | Cathy C. Dugan |
First Address | Oakland, CA 94612-3466 |
Second Address | Walnut Creek, CA 94596-5318 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 08/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G795220 | (05) | CA |
H76450 | (02) |