Organization Active NPI

Dahlia Bu MD a Prof Corp.

  • Obstetrics & Gynecology Physician
  • Fair Oaks, CA
National Provider Identifier
1205954351
Registry record updated Oct 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
G40859 Issued in CA
Legal business name
DAHLIA BU MD A PROF CORP.
Practice address
5525 Dewey Dr
108
Fair Oaks, CA 95628
Phone
(916) 961-2800
Fax
(916) 961-7264
NPI assigned
Mar 27, 2007
Last updated
Oct 20, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dahlia Bu, MDNPI 1770754087
Title
MD
Phone
(916) 961-2800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X G40859 CA Primary

Addresses

Primary practice location

5525 Dewey Dr
108
Fair Oaks, CA 95628

Mailing address

5525 Dewey Dr
108
Fair Oaks, CA 95628
Phone (916) 961-2800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111024000051 CA Part B Supplier - Clinic/Group Practice 7416120233 Receives reassigned benefits from 1 practitioner
Practice locations: Fair Oaks, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0941047Dahlia Bu MD5525 Dewey Dr, #108, Fair Oaks, CA 95628Certificate of waiverFeb 18, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319068800000",
    "number": "1205954351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5525 DEWEY DR",
            "address_2": "108",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "95628",
            "telephone_number": "916-961-2800",
            "fax_number": "916-961-7264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5525 DEWEY DR",
            "address_2": "108",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "95628",
            "telephone_number": "916-961-2800",
            "fax_number": "916-961-7264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAHLIA BU MD A PROF CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2011-10-20",
        "status": "A",
        "authorized_official_last_name": "BU",
        "authorized_official_first_name": "DAHLIA",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "916-961-2800",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "G40859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fair Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.