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Individual

DR. DANIEL LINK FORTMANN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
32281 CAMINO CAPISTRANO, SUITE C-102, SAN JUAN CAPISTRANO, CA 92675-3784
(949) 493-7981
(949) 493-0114
Mailing address
32281 CAMINO CAPISTRANO, SUITE C-102, SAN JUAN CAPISTRANO, CA 92675-3784
(949) 493-7981
(949) 493-0114

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
A37462
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00A374620
MEDI-CAL
CA
01
1114197142
NPI TYPE I
CA
01
1881667400
NPI TYPE II
CA
01
WA37462O
MEDICARE PPIN
CA
Enumeration date
03/05/2008
Last updated
03/06/2008
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