Mr. Dane Edward Weatherford, IDC - San Diego, CA

Mr. Dane Edward Weatherford, IDC

Military Health Care Provider in San Diego, California

NPI 1053686824

Dane Edward Weatherford is a Military Health Care Provider based in San Diego, CA. Dane Edward Weatherford practices in San Diego, CA and has the professional credentials of IDC. The NPI Number for Dane Edward Weatherford is 1053686824 and holds a License No. (California).

The current practice location address for Dane Edward Weatherford is 10209 Hooper St, San Diego, CA and can be reached out via phone at 860-501-0511.

Location: 10209 Hooper St, San Diego, CA, 92124-3509

NPI Number

1053686824

Provider Name

Dane Edward Weatherford

Credential

IDC

Provider Entity Type

Individual

Gender

Male

Address

10209 Hooper St, San Diego, CA, 92124-3509

Phone Number

860-501-0511

Fax Number

Provider Enumeration Date

03/13/2012

Last Update Date

03/09/2024

Address

10209 Hooper St

City

San Diego

State

California

Zip

92124-3509

Phone Number

860-501-0511

Fax Number

Address

10209 Hooper St

City

San Diego

State

California

Zip

92124-3509

Phone Number

860-501-0511

Fax Number

Type

Other Service Providers

Classification

Military Health Care Provider

Speciality

Taxonomy

171000000X

License No.

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Definition

Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.

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