Provider Demographics
NPI:1508893744
Name:DANCIGER, HARVEY (DPM)
Entity Type:Individual
Prefix:
First Name:HARVEY
Middle Name:
Last Name:DANCIGER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74000 COUNTRY CLUB DRIVE
Mailing Address - Street 2:STE A2
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92260-1677
Mailing Address - Country:US
Mailing Address - Phone:760-568-0108
Mailing Address - Fax:760-568-5110
Practice Address - Street 1:74000 COUNTRY CLUB DRIVE
Practice Address - Street 2:STE A2
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92260-1677
Practice Address - Country:US
Practice Address - Phone:760-568-0108
Practice Address - Fax:760-568-5110
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-26
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE2179213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA4810240001Medicare NSC
CA000E21790Medicare PIN
T19171Medicare UPIN