Individual provider · Type 1 NPI

Dane Edward Weatherford, IDC

Military Health Care Provider · San Diego, CA

NPI number 1053686824 Active

Practice location

10209 Hooper St
San Diego, CA 92124-3509

Call (860) 501-0511 Map

Specialties and licenses

TaxonomyCodeLicense
Military Health Care Provider Primary 171000000XNone listed

Military Health Care Provider: 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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About NPI 1053686824

Dane Edward Weatherford, IDC's National Provider Identifier is 1053686824, issued on Mar 13, 2012. The primary taxonomy on file is Military Health Care Provider (171000000X), and the practice location is in San Diego, CA. The record was last updated on Mar 13, 2012.