Individual
DR. DOUGLAS DEAN DENGERINK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
6699 ALVARADO RD, SUITE 2100, SAN DIEGO, CA 92120-5244
(619) 229-3909
(619) 229-3902
Mailing address
6699 ALVARADO RD, SUITE 2100, SAN DIEGO, CA 92120-5244
(619) 229-3909
(619) 229-3902
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
20A9206
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GL046Z
MEDICARE PTAN
CA
Enumeration date
06/24/2005
Last updated
09/13/2012
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