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Individual

DR. DAVID J HEANEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
515 W ACEQUIA AVE STE A, VISALIA, CA 93291-6131
(559) 733-9707
(559) 733-7009
Mailing address
515 W ACEQUIA AVE STE A, VISALIA, CA 93291-6131
(559) 733-9707
(559) 733-7009

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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