Ilsook Park Dahlin, FNP
Individual provider Active NPI Family Nurse Practitioner · Coarsegold, CA
NPI 1528899622 · NPPES record last updated Aug 10, 2024
Key facts
- NPI
- 1528899622
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 95031582 (CA)
- Practice address
- 35463 Highway 41
Coarsegold, CA 93614-8722 - Phone
- (559) 683-6292
- NPI assigned
- Aug 10, 2024
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 25
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Camarena Health
Practice addresses (Care Compare)
344 E 6TH St
Madera, CA 93638-3631
Phone (559) 664-4000
35463 Hwy 41
Coarsegold, CA 93614-8722
Phone (559) 683-6292
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241008002022 | CA | Practitioner - Nurse Practitioner | 9931473774 |
Reassigns benefits to 1 organization Practice locations: Coarsegold, CA |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95031582 | CA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Camarena Health | Current |
Accepting new patients | |
| Coarsegold Creek Medical Center | Current |
Accepting new patients | |
| Camarena Health | Current |
Accepting new patients | |
| Camarena Health | Family | Current | Accepting new patients |
Locations
35324 Highway 41
Ste A
Coarsegold, CA 93614
Phone (559) 222-6500
35463 Highway 41
Coarsegold, CA 93614
Phone (559) 683-6292
49169 Road 426
Oakhurst, CA 93644
Phone (559) 642-6724
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 95031582 | CA | Yes |
Addresses
Primary practice location
35463 Highway 41
Coarsegold, CA 93614-8722
Mailing address
PO Box 970
Coarsegold, CA 93614-0970
Phone (559) 246-8014
Other providers in Coarsegold, CA
- Melissa Campos
- Central Valley Mobility
- Coarsegold Creek Medical Center
- Coarsegold Physical Therapy, Incorporated
- Lisa Crassi
- Stephen Dahlin
- Irene Rojas Elizondo
- Maria Denise Elliott
- Martha Grace Foster
- John Eric Francom
All providers in Coarsegold, CA · Family Nurse Practitioner in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 10, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.