Organization
MUDIT DABRAL, M.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MUDIT DABRAL M.D. (OWNER)
(805) 928-9770
Entity
Organization
Contact information
Practice address
1505 SHEPARD DR, SUITE 105, SANTA MARIA, CA 93454-7020
(805) 928-9770
(805) 928-6350
Mailing address
1505 SHEPARD DR, SUITE 105, SANTA MARIA, CA 93454-7020
(805) 928-9770
(805) 928-6350
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
A40705
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0098760
—
CA
01
—
ZZZ09774Z
BLUE SHIELD OF CA GRP #
CA
Enumeration date
11/08/2006
Last updated
04/20/2008
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