Basic Information
Provider Information
NPI: 1518953694
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DELL
FirstName: JEFFREY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
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Mailing Information
Address1: 100 E VALENCIA MESA DR STE 206
Address2:  
City: FULLERTON
State: CA
PostalCode: 928353817
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 100 E VALENCIA MESA DR
Address2: SUITE 206
City: FULLERTON
State: CA
PostalCode: 928353813
CountryCode: US
TelephoneNumber: 7144465050
FaxNumber: 7144465150
Other Information
ProviderEnumerationDate: 09/23/2005
LastUpdateDate: 10/21/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/21/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XG39875CAN Allopathic & Osteopathic PhysiciansInternal Medicine 
207RC0000XG39875CAY Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease

No ID Information.


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