Provider Demographics
NPI:1992770069
Name:DUGAN, PAUL J (MD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:J
Last Name:DUGAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1100 TRANCAS ST
Mailing Address - Street 2:SUITE 256
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-2908
Mailing Address - Country:US
Mailing Address - Phone:707-253-7161
Mailing Address - Fax:707-253-0476
Practice Address - Street 1:1100 TRANCAS ST
Practice Address - Street 2:SUITE 256
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558-2908
Practice Address - Country:US
Practice Address - Phone:707-253-7161
Practice Address - Fax:707-253-0476
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2015-02-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG55000207RH0003X, 207RX0202X, 207RH0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G550000Medicaid
E45321Medicare UPIN
CACA115638Medicare PIN