Individual
BRENT C DAWSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
3304 RENNER DR, FORTUNA, CA 95540-7102
(707) 725-9383
(707) 725-1140
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 285-4650
(801) 285-4651
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
8289902-1206
UT
363AS0400X
Surgical Physician Assistant
PA21433
CA
Other
Enumeration date
01/27/2011
Last updated
06/14/2017
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