Provider Demographics
NPI:1902099708
Name:DOZIER, EMANUEL VINCENT (MD, MPH)
Entity Type:Individual
Prefix:
First Name:EMANUEL
Middle Name:VINCENT
Last Name:DOZIER
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2129 17TH STREET
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-3704
Mailing Address - Country:US
Mailing Address - Phone:661-859-2211
Mailing Address - Fax:661-859-2214
Practice Address - Street 1:2129 17TH ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-3704
Practice Address - Country:US
Practice Address - Phone:661-859-2211
Practice Address - Fax:661-859-2214
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-24
Last Update Date:2007-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG753220207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G753220Medicaid
CAC45697Medicare UPIN