Individual
DR. DARYL RAY DUTTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
521 N WILMA AVE STE A, RIPON, CA 95366-9003
(209) 599-4211
(209) 599-4341
Mailing address
450 GLASS LN STE C, MODESTO, CA 95356-9287
(209) 342-2300
(209) 524-4240
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G57233
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G572330
—
CA
01
—
080009801
RAILROAD MEDICARE
CA
01
—
68-0311001
TAX ID
CA
Enumeration date
06/17/2005
Last updated
11/19/2024
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