Provider Demographics
NPI:1871721100
Name:DUGAN, SEAN PATRICK
Entity type:Individual
Prefix:DR
First Name:SEAN
Middle Name:PATRICK
Last Name:DUGAN
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:SEAN
Other - Middle Name:PATRICK
Other - Last Name:DUGAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 992790
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-4245
Mailing Address - Country:US
Mailing Address - Phone:530-246-5702
Mailing Address - Fax:530-245-9830
Practice Address - Street 1:1035 PLACER ST
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-4545
Practice Address - Country:US
Practice Address - Phone:530-248-5702
Practice Address - Fax:530-245-9830
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-25
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA121229208D00000X
HI5706390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program