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Individual

STEPHEN LEWIS DALTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
400 PROFESSIONAL CENTER DR, SUITE 414, NOVATO, CA 94947-4367
(415) 892-0754
(415) 897-3204
Mailing address
400 PROFESSIONAL CENTER DR, SUITE 414, NOVATO, CA 94947-4367
(415) 892-0754
(415) 897-3204

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
A62214
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P00429886
RAILROAD MEDICARE
CA
Enumeration date
07/07/2005
Last updated
10/09/2008
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