Dorothy Ellen Comeau, PH.D.M.D.

Individual provider Active NPI General Practice Physician · Topanga, CA

NPI 1366770570 · NPPES record last updated Nov 28, 2009

Key facts

NPI
1366770570
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Physician 208D00000X
License
G78982 (CA)
Practice address
21587 Encina Rd
Topanga, CA 90290-3523
Phone
(310) 455-1632
Fax
(310) 455-9352
NPI assigned
Nov 28, 2009
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G78982CAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rapid City Indian Health Service Hospital Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X G78982 CA Yes

Addresses

Primary practice location

21587 Encina Rd
Topanga, CA 90290-3523

Mailing address

21587 Encina Rd
Topanga, CA 90290-3523
Phone (310) 455-1632

Other providers in Topanga, CA

All providers in Topanga, CA · General Practice Physician in California

Sources for this page

Verify at the official NPI Registry.