Individual
DAWN TERESE TANNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
27700 MEDICAL CENTER RD, MISSION VIEJO, CA 92691-6426
(949) 364-7744
Mailing address
28202 CABOT RD STE 300, LAGUNA NIGUEL, CA 92677-1249
(949) 365-5765
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
5876
NE
2085R0202X
Diagnostic Radiology Physician
Primary
A110702
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A1107020
BC/BS OF CA
CA
05
—
1104089606
—
CA
Enumeration date
07/03/2008
Last updated
07/22/2014
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