Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | G76791 | CA |
N | 2081P2900X | Pain Medicine | 7678772-1205 | UT |
NPI | 1114091105 |
---|---|
Provider Name | Dr. John A Dana JR. |
First Address | Walnut Creek, CA 94597-2168 |
Second Address | Walnut Creek, CA 94597-2168 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/11/2006 |
Last Update Date | 18/03/2019 |