Individual
DENNIS ALLEN MINAS FITO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6 TARMAN DR, CLOVERDALE, CA 95425-3932
(707) 894-4229
Mailing address
6 TARMAN DR, CLOVERDALE, CA 95425-3932
(707) 894-4229
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25193
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200244560A
—
OK
Enumeration date
06/15/2009
Last updated
09/01/2020
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