Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 0101048500 | VA |
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 0101048500 | VA |
NPI | 1265405096 |
---|---|
Provider Name | Dr. Bonnie J Dattel |
First Address | Santa Barbara, CA 93160-6272 |
Second Address | Santa Barbara, CA 93105-4305 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/02/2006 |
Last Update Date | 08/06/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
006259995 | (05) | VA |
-010 | TRICARE/CHAMPUS (01) | VA |
0595T | BC/BS (01) | NC |
092616 | ANTHEM (01) | VA |
14051 | SENTARA OPTIMA (01) | VA |
227480 | UHC/MAMSI (01) | VA |
890595T | (05) | NC |
A49463 | (02) | VA |
G43784 | MEDICAL LICENSE (01) | CA |
PAR | AETNA (01) | VA |
PAR | CIGNA (01) | VA |
PAR | CORVEL/CORCARE (01) | VA |
PAR | FIRST HEALTH COMMERCIAL/SOUTHERN HEALTH/COVENTRY (01) | VA |
PAR | MULTIPLAN (01) | VA |
PAR | USA MANAGED CARE (01) | VA |
PAR | VIRGINIA HEALTH NETWORK (01) | VA |
PAR | VIRGINIA PREMIER HEALTH (01) | VA |