Provider Demographics
NPI:1861936304
Name:DUNN, DASHAUN DANIEL
Entity type:Individual
Prefix:MR
First Name:DASHAUN
Middle Name:DANIEL
Last Name:DUNN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:516 DERBY ROAD
Mailing Address - Street 2:
Mailing Address - City:SAN DIMAS
Mailing Address - State:CA
Mailing Address - Zip Code:91773-6246
Mailing Address - Country:US
Mailing Address - Phone:310-863-8933
Mailing Address - Fax:
Practice Address - Street 1:516 DERBY RD
Practice Address - Street 2:
Practice Address - City:SAN DIMAS
Practice Address - State:CA
Practice Address - Zip Code:91773-2479
Practice Address - Country:US
Practice Address - Phone:310-863-8933
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-16
Last Update Date:2016-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program