Dickinson, Diane
Dickinson, Diane is an sole proprietor health care provider with primary practice located at 4058 D St , Eureka CA 95503-6025. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Dickinson, Diane can be contacted via phone (707) 599-1561.Contact Information
Primary practice address
4058 D St
Eureka CA 95503-6025
Phone: (707) 599-1561
Fax: (707) 825-1116
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | G69727 | California |
Profile Details
| NPI number | 1104860519 |
|---|---|
| LBN Legal business name | Dickinson, Diane |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 15th, 2006 |
| Last updated | Apr 1st, 2013 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104860519 | NPPES |
| California | MEDICAID | 00G697270 |
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