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Individual

MR. DOUGLAS M DALITZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
23 UPPER RAGSDALE DR STE 100, MONTEREY, CA 93940-7849
(831) 375-3577
Mailing address
416B MAIN ST, SALINAS, CA 93901-3306
(831) 800-7887
(831) 998-7155

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
303557
CA
367500000X
Certified Registered Nurse Anesthetist
059417
MO
367500000X
Certified Registered Nurse Anesthetist
Primary
10
CA
367500000X
Certified Registered Nurse Anesthetist
TCRNA800146
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
915920714
MO
Enumeration date
07/14/2006
Last updated
07/24/2023
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