Provider Demographics
NPI:1285671222
Name:VANHAMERSVELD, DANIEL DALE (MD)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:DALE
Last Name:VANHAMERSVELD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 UNIVERSITY AVE.
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-6524
Mailing Address - Country:US
Mailing Address - Phone:916-830-2000
Mailing Address - Fax:916-830-2001
Practice Address - Street 1:500 UNIVERSITY AVE.
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-6524
Practice Address - Country:US
Practice Address - Phone:916-830-2000
Practice Address - Fax:916-830-2001
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG441841207RC0000X
CAG44184207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G441840Medicaid
CAA49574Medicare UPIN
CA00G441841Medicare PIN
CA00G441840Medicaid