| Doctor Name: | BRENT C DAWSON |
| NPI Number: | 1548566276 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | P.A. |
| License Number: | PA21433 |
| Business Practice Address: | 3304 Renner Dr Fortuna, CA - 955407102 |
| Business Phone Number: | 7077259383 |
| Business Fax Number: | 7077251140 |
| Mailing Address: | 279 Imperial Hwy, Suite 730 FULLERTON |
| State: | CA |
| Postal Code: | 928351041 |
| Phone Number: | 7144494841 |
| Fax Number: | 7144494956 |
| NPI Enumeration Date: | 01/27/2011 |
| NPI Last Update Date: | 06/27/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AS0400X |
| License Number: | PA21433 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Surgical |
| Taxonomy Definition: | |