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Individual

DANIEL MARTIN HAYCRAFT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
913 WASHINGTON ST, CALISTOGA, CA 94515-1433
(707) 942-0844
(707) 942-6382
Mailing address
913 WASHINGTON ST, CALISTOGA, CA 94515-1433
(707) 942-6233
(707) 942-6382

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
36-101144
IL
2084P0800X
Psychiatry Physician
Primary
C56075
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01627888
BLUE CROSS
IL
01
036-101144
ILLINOIS MEDICAL LICENSE
IL
05
036101144
IL
01
C56075
CALIFORNIA MEDICAL LICENSE
CA
Enumeration date
12/14/2006
Last updated
08/03/2022
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