Provider Demographics
NPI:1083667307
Name:HEICHEL, CHRISTOPHER WILLIAM DANA (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:WILLIAM DANA
Last Name:HEICHEL
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Gender:M
Credentials:MD
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Mailing Address - Street 1:9415 CAMPUS POINT DRIVE
Mailing Address - Street 2:UCSD SHILEY EYE CENTER MC 0946
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92093-0946
Mailing Address - Country:US
Mailing Address - Phone:858-822-4848
Mailing Address - Fax:858-822-4846
Practice Address - Street 1:UCSD MEDICAL CENTER
Practice Address - Street 2:200 WEST ARBOR DRIVE MC 8201
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-8201
Practice Address - Country:US
Practice Address - Phone:858-534-6290
Practice Address - Fax:858-822-1849
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
CAA75001207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A750010Medicaid
CAWA75001AMedicare ID - Type Unspecified
CAH84117Medicare UPIN