Individual
DR. PAUL LOUIS DIMODICA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3043 NE 28TH ST, LINCOLN CITY, OR 97367-4518
(541) 994-3661
Mailing address
PO BOX 1194, CORVALLIS, OR 97339-1194
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
20A8624
CA
207P00000X
Emergency Medicine Physician
Primary
DO24715
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00AX86240
—
CA
Enumeration date
06/26/2006
Last updated
03/21/2022
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