Individual
DAWIT MAMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
16070 TUSCOLA RD, SUITE 101, APPLE VALLEY, CA 92307-1320
(760) 242-4000
(760) 242-5250
Mailing address
PO BOX 3800, APPLE VALLEY, CA 92307-0074
(760) 242-4000
(760) 242-5250
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
A54482
CA
207R00000X
Internal Medicine Physician
Primary
A54482
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A544820
—
CA
Enumeration date
08/11/2006
Last updated
10/09/2008
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