Individual
BRIAN WALLACE DORMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2576 RENFREN STREET, EUREKA, CA 95501
(707) 445-3257
(707) 445-1027
Mailing address
2576 RENFREN STREET, EUREKA, CA 95501
(707) 445-3257
(707) 445-1027
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
G24506
CA
Other
Enumeration date
07/18/2006
Last updated
10/21/2021
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