Provider Demographics
NPI:1285942730
Name:WILLIAM M DOLAN MD A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:WILLIAM M DOLAN MD A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:M
Authorized Official - Last Name:DOLAN
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:650-941-8567
Mailing Address - Street 1:771 WOODSTOCK LN
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94022-3965
Mailing Address - Country:US
Mailing Address - Phone:650-941-8567
Mailing Address - Fax:650-941-8322
Practice Address - Street 1:771 WOODSTOCK LN
Practice Address - Street 2:
Practice Address - City:LOS ALTOS
Practice Address - State:CA
Practice Address - Zip Code:94022-3965
Practice Address - Country:US
Practice Address - Phone:650-941-8567
Practice Address - Fax:650-941-8322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-17
Last Update Date:2010-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC31652207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty