Provider Demographics
NPI:1053581462
Name:DAWSON, KAREN BURGOS (PA-C)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:BURGOS
Last Name:DAWSON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13323 REVA ST
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-8727
Mailing Address - Country:US
Mailing Address - Phone:562-926-4769
Mailing Address - Fax:
Practice Address - Street 1:1801 W ROMNEYA DR
Practice Address - Street 2:203
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-1830
Practice Address - Country:US
Practice Address - Phone:714-999-1465
Practice Address - Fax:714-999-1701
Is Sole Proprietor?:No
Enumeration Date:2008-03-03
Last Update Date:2012-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA19600363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant