Provider Demographics
NPI:1396758900
Name:DAGHER, MAY K (MD)
Entity type:Individual
Prefix:MRS
First Name:MAY
Middle Name:K
Last Name:DAGHER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:631 N 13TH AVENUE
Mailing Address - Street 2:STE E
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-4978
Mailing Address - Country:US
Mailing Address - Phone:909-946-6676
Mailing Address - Fax:909-946-7368
Practice Address - Street 1:631 N 13TH AVENUE
Practice Address - Street 2:STE E
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-4978
Practice Address - Country:US
Practice Address - Phone:909-946-6676
Practice Address - Fax:909-946-7368
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA73681208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics