Basic Information
| Provider Information | |||||||||
| NPI: | 1780915678 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ELMESEWDY | ||||||||
| FirstName: | DINAH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 156 PARNASSUS AVE | ||||||||
| Address2: | APT 6 | ||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941174252 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4155666694 | ||||||||
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| Practice Location | |||||||||
| Address1: | 975 S FAIRMONT AVE | ||||||||
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| City: | LODI | ||||||||
| State: | CA | ||||||||
| PostalCode: | 952405118 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2093343411 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/17/2010 | ||||||||
| LastUpdateDate: | 02/11/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2100X | 19445 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care |
No ID Information.