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IMAD S. DANDAN M.D. NPI 1982708384


NPI Information

NPI: 1982708384
Provider Name: IMAD S. DANDAN, M.D.
Classification: Surgery - 2086S0127X
Entity Type: Individual

Specialization: Trauma Surgery

PECOS Registration: Yes

Address:
9888 GENESEE AVE
LJ-601
LA JOLLA, CA
ZIP 92037
Phone: (858) 626-6362
Get Directions

Imad S. Dandan, M.D. is a trauma surgery surgery in La Jolla, CA with 41 years of experience. The provider is trauma surgery is a recognized subspecialty of general surgery. Trauma surgeons are physicians who have completed a five-year general surgery residency and usually continue with a one to two year fellowship in trauma and/or surgical critical care, typically leading to additional board certification in surgical critical care. There is no trauma surgery board certification at this point. To obtain board certification in surgical critical care, a fellowship in surgical critical care or anesthesiology critical care must be completed during or after general surgery residency. Imad S. Dandan, M.D. NPI is 1982708384. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

9888 GENESEE AVE
LJ-601
LA JOLLA, CA
ZIP 92037-205
Phone: (858) 626-6362
Fax: (858) 626-6354

The NPI 1982708384 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/7/2006 and was last updated on 7/8/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12086S0127XSurgeryTrauma SurgeryA45893CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1W18942MEDICARE ID-TYPE UNSPECIFIEDCALIFORNIA
2E71888MEDICARE UPIN
300A458930MEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.