Basic Information
Provider Information
NPI: 1841250594
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: VOLQUARTSEN
FirstName: DALE
MiddleName: A
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2450 SISTER MARY COLUMBA DR
Address2:  
City: RED BLUFF
State: CA
PostalCode: 960804356
CountryCode: US
TelephoneNumber: 5305270414
FaxNumber: 5305273720
Practice Location
Address1: 2450 SISTER MARY COLUMBA DR
Address2:  
City: RED BLUFF
State: CA
PostalCode: 960804356
CountryCode: US
TelephoneNumber: 5305270414
FaxNumber: 5305273720
Other Information
ProviderEnumerationDate: 03/26/2006
LastUpdateDate: 01/29/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000X19843NEY Allopathic & Osteopathic PhysiciansPediatrics 

No ID Information.


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