Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | C3731601 | CA |
NPI | 1033232483 |
---|---|
Provider Name | Dr. Eric Jay Dolgin |
First Address | Santa Monica, CA 90405-1718 |
Second Address | Santa Monica, CA 90405-1718 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2007 |
Last Update Date | 08/07/2007 |