Individual
DALE LEROY MORRISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
244 HOSPITAL DR, STE B, UKIAH, CA 95482-4557
(707) 463-8070
(707) 463-8075
Mailing address
3536 MENDOCINO AVE, STE 200, SANTA ROSA, CA 95403-3634
(707) 525-6485
(707) 463-8075
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
G23143
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G231430
BLUE SHIELD OF CALIFORNIA
CA
05
—
00G231430
—
CA
01
—
P00175066
RAILROAD MEDICARE
CA
Enumeration date
07/13/2005
Last updated
02/08/2012
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