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Individual
DR. DAVID J HEANEY
Active
Individual
DR. DAVID J HEANEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A301420
CA
207RN0300X
Nephrology Physician
Primary
A301420
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A301420
—
CA
01
—
05D0864240
CLIA NUMBER
CA
01
—
1013123686
NPPES-TULARE LOCATION
CA
01
—
1588879175
NPPES-VISALIA LOCATION
CA
01
—
1972710127
NPPES-PORTERVILLE LOC.
CA
01
—
942512154
FED TAX ID #
CA
01
—
A30142
CALIF. MEDICAL BOARD
CA
Enumeration date
09/19/2005
Last updated
09/29/2011
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