Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | 54950 | CA |
NPI | 1104335934 |
---|---|
Provider Name | Mrs. Dawn Michelle Vollmann |
First Address | Anaheim, CA 92805-3423 |
Second Address | Brea, CA 92821-5377 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2017 |
Last Update Date | 25/09/2017 |