| Provider / Organization | NPI | Date Certified |
|---|---|---|
| DOMINIC T DIZON | 1659384295 | 2024-09-07 |
Dominic T Dizon [M] graduated in 1995 from University Of California, Davis School Of Medicine and primarily specializes in Internal Medicine.
Dominic T Dizon is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1659384295. Registration indicates Dominic T Dizon is a provider of access to adult/geriatric primary care providers services with a specialization in Allopathic & Osteopathic Physicians, Internal Medicine Access to Pediatric Primary Care Providers (Allopathic & Osteopathic Physicians, Internal Medicine) (Internal Medicine, ) (Allopathic & Osteopathic Physicians, Internal Medicine) (Primary Care/Family Planning/APRN/PA, ) (Internal Medicine, Allopathic & Osteopathic Physicians)
| PECOS ID | 840356325 |
| Registration | PART-B:Y DME:Y HHA:Y PMD:Y |
| Entity Type | Individual |
| Provider Name | Dominic T Dizon M.D. |
| Practice Office Address | 7035 N MAPLE AVE STE 102B FRESNO, CA US |
| Practice Office Telephone | 5592992997 |
| Mailing Address | 7035 N MAPLE AVE STE 102B FRESNO, CA 937208026 US |
| Business Telephone | 5592992997 |
| Address | City / State | Phone / Fax |
|---|---|---|
| 2335 E Kashian Ln Ste 280 | Fresno, CA 937012211 | 5593201090 / 5593200331 |
| Code | Practice | License No State |
|---|---|---|
| 207R00000X PRIMARY | Access to Adult/Geriatric Primary Care Providers Allopathic & Osteopathic Physicians Internal MedicineAccess to Pediatric Primary Care Providers Allopathic & Osteopathic Physicians Internal Medicine Internal Medicine Allopathic & Osteopathic Physicians Internal Medicine Primary Care/Family Planning/APRN/PA Internal Medicine Allopathic & Osteopathic Physicians | A62295
CA |
| 00A622950 | MEDICAID | CA |