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| Type | Person | [sources] | |||
|---|---|---|---|---|---|
| Name | Gus W. Dixon, Jr. | [sources] | |||
| Birth date | not available | [sources] | |||
| Nationality | not available | [sources] | |||
| Country | United States | [sources] | |||
| First name | Gus | [sources] | |||
| Last name | Dixon, Jr. | [sources] | |||
| Middle name | W. | [sources] | |||
| Registration number | 00G507750 · 00G507751 · 00G507752 · 00G507753 · G50775 | [sources] | |||
| Sector | Physician | [sources] | |||
| Address | 412 Termino Avenue, Long Beach, CA, 90814 | [sources] | |||
| Last change | Last processed | First seen | |||
Medical providers suspended from or otherwise deemed ineligible to participate in California's Medicaid program.
United States · DHCS
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