Organization Active NPI

Mudit Dabral, M.D.

  • Pulmonary Disease Physician
  • Santa Maria, CA
National Provider Identifier
1447320569
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
A40705 Issued in CA
Legal business name
MUDIT DABRAL, M.D.
Practice address
1505 Shepard Dr
Suite 105
Santa Maria, CA 93454-7020
Phone
(805) 928-9770
Fax
(805) 928-6350
NPI assigned
Nov 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Dr. Mudit Dabral, M.D.NPI 1477623585
Title
Owner
Phone
(805) 928-9770

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
Pulmonary Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RP1001X A40705 CA Primary

Addresses

Primary practice location

1505 Shepard Dr
Suite 105
Santa Maria, CA 93454-7020

Mailing address

1505 Shepard Dr
Suite 105
Santa Maria, CA 93454-7020
Phone (805) 928-9770

Other identifiers 2

IdentifierTypeStateIssuer
ZZZ09774ZOtherCABLUE SHIELD OF CA GRP #
GR0098760MedicaidCA

National Provider Directory

National Provider Directory

Locations

1505 Shepard Dr
Ste 105
Santa Maria, CA 93454
Phone (805) 928-9770

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1447320569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 SHEPARD DR",
            "address_2": "SUITE 105",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934547020",
            "telephone_number": "805-928-9770",
            "fax_number": "805-928-6350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 SHEPARD DR",
            "address_2": "SUITE 105",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934547020",
            "telephone_number": "805-928-9770",
            "fax_number": "805-928-6350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUDIT DABRAL, M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "DABRAL",
        "authorized_official_first_name": "MUDIT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "805-928-9770",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "A40705",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CA GRP #",
            "identifier": "ZZZ09774Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0098760",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Maria, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.