Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | G11597 | CA |
NPI | 1003841180 |
---|---|
Provider Name | Mr. Donald Henry Heithecker |
First Address | Chico, CA 95926 |
Second Address | Chico, CA 95926 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2006 |
Last Update Date | 27/01/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G115970 | (05) | CA |
A38394 | (02) |