Individual
DAN L HEYERDAHL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2833 CLINTON TERRACE, SANTA BARBARA, CA 93105
(920) 850-8941
Mailing address
2833 CLINTON TERRACE, SANTA BARBARA, CA 93105
(920) 850-8941
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
22397-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30410700
—
WI
Enumeration date
09/20/2005
Last updated
03/04/2016
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