Provider Demographics
NPI:1174887368
Name:HINKLE, DAWN (PA-C)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:HINKLE
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:DAWN
Other - Middle Name:
Other - Last Name:HORSEMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:3841 HIAWATHA WAY
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92117-4644
Mailing Address - Country:US
Mailing Address - Phone:831-239-2499
Mailing Address - Fax:
Practice Address - Street 1:6525 LA JOLLA BLVD
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-6016
Practice Address - Country:US
Practice Address - Phone:858-454-5557
Practice Address - Fax:858-454-2223
Is Sole Proprietor?:No
Enumeration Date:2012-07-02
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA22338363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant