Tyler Scandalis Dawson, is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in Glendale, California. His current practice location is
1509 Wilson Ter, Glendale, California. You can reach out to his office (for appointments etc.) via phone at
(818) 409-8000.
Tyler Scandalis Dawson is licensed to practice in * (Not Available) (license number ) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1891438990.
Physician's Profile
Full Name | Tyler Scandalis Dawson |
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Gender | Male |
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Speciality | Student In An Organized Health Care Education/training Program |
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Location | 1509 Wilson Ter, Glendale, California |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1891438990
- Provider Enumeration Date: 04/16/2022
- Last Update Date: 07/20/2025
Medicare PECOS Information:
- PECOS PAC ID: 3971989674
- Enrollment ID: I20221004001714
Medical Identifiers
Medical identifiers for Tyler Scandalis Dawson such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1891438990 | NPI | - | NPPES |
20A21772 | Other | CA | CALIFORNIA MEDICAL LICENSE # |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207Q00000X | Family Medicine | 20A21772 (California) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Tyler Scandalis Dawson is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Tyler Scandalis Dawson, 7405 Magellan St, Carlsbad, CA 92011-5410 Ph: () - | Tyler Scandalis Dawson, 1509 Wilson Ter, Glendale, CA 91206-4007 Ph: (818) 409-8000 |
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