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BRENT C DAWSON P.A.
Surgical >> Physician Assistant >> Physician Assistants & Advanced Practice Nursing ProvidersRegistrant NPI Number: 1548566276
Individual Registrant: BRENT C DAWSON P.A.
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
3304 RENNER DR FORTUNA, CA 95540-7102 US
Tel: 707-725-9383 Fax: 707-725-1140
Tel: 707-725-9383 Fax: 707-725-1140
Contact information for business:
PO BOX 27128 SALT LAKE CITY, UT 84127-0128 US
Tel: 801-285-4650 Fax: 801-285-4651
Tel: 801-285-4650 Fax: 801-285-4651
Registration Information:
NPI: 1548566276
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 363AS0400X | Physician Assistants & Advanced Practice Nursing Providers Physician Assistant Surgical | CA | PA21433 |
| Y | 363A00000X | Physician Assistants & Advanced Practice Nursing Providers Physician Assistant | UT | 8289902-1206 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
