Organization
DARYL R DUTTER MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DARYL R DUTTER MD (PRESIDENT)
(209) 599-4211
Entity
Organization
Contact information
Practice address
521 N WILMA AVE STE A, RIPON, CA 95366-9503
(209) 599-4211
(209) 599-7348
Mailing address
PO BOX 210, RIPON, CA 95366-0210
(209) 599-4211
(209) 599-4341
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
Enumeration date
06/08/2010
Last updated
01/03/2022
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