Individual
MUDIT DABRAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
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, SUIE 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
01
—
00A407050
BLUE SHIELD
CA
05
—
00A407050
—
CA
01
—
0480598
AETNA PIN
CA
01
—
1087
CMSP
CA
01
—
770154235 93454 A002
CHAMPUS TRICARE PIN
CA
Enumeration date
11/08/2006
Last updated
09/23/2011
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