Individual
MR. DANA CHARLES NIENDORF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1496 PROFESSIONAL DR, STE 603, PETALUMA, CA 94954
(707) 762-0059
(707) 762-8011
Mailing address
1496 PROFESSIONAL DR, STE 603, PETALUMA, CA 94954
(707) 762-0059
(707) 762-8011
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
G24293
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5233018
—
CA
Enumeration date
08/08/2006
Last updated
07/08/2007
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