Erwin Inciong Dimaculangan

Individual provider Active NPI Licensed Vocational Nurse · Dixon, CA

NPI 1063199784 · NPPES record last updated Jul 4, 2023

Key facts

NPI
1063199784
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Vocational Nurse 164X00000X
License
291339 (CA)
Practice address
655 S Lincoln St
Dixon, CA 95620-9419
Phone
(650) 892-1842
NPI assigned
Jul 4, 2023
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 291339 CA Yes

Addresses

Primary practice location

655 S Lincoln St
Dixon, CA 95620-9419

Mailing address

655 S Lincoln St
Dixon, CA 95620-9419
Phone (650) 892-1842

Other providers in Dixon, CA

All providers in Dixon, CA · Licensed Vocational Nurse in California

Sources for this page

Verify at the official NPI Registry.