Provider Demographics
NPI:1386646180
Name:HARWOOD, DANIEL W (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:W
Last Name:HARWOOD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 496084
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96049-6084
Mailing Address - Country:US
Mailing Address - Phone:530-241-0473
Mailing Address - Fax:530-229-3703
Practice Address - Street 1:106 GARDEN GULCH
Practice Address - Street 2:
Practice Address - City:WEAVERVILLE
Practice Address - State:CA
Practice Address - Zip Code:96093-2280
Practice Address - Country:US
Practice Address - Phone:530-623-3600
Practice Address - Fax:530-623-1677
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-11
Last Update Date:2018-05-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG57785208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G577850Medicaid
CA00G577850Medicare ID - Type Unspecified
CA00G577850Medicaid