Provider Demographics
NPI:1659424604
Name:DANZ, WILLIAM ALLEN (BCO)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:ALLEN
Last Name:DANZ
Suffix:
Gender:M
Credentials:BCO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:490 POST ST
Mailing Address - Street 2:STE. 1609
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-1401
Mailing Address - Country:US
Mailing Address - Phone:415-433-3990
Mailing Address - Fax:415-986-0491
Practice Address - Street 1:490 POST ST
Practice Address - Street 2:STE. 1609
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-1401
Practice Address - Country:US
Practice Address - Phone:415-433-3990
Practice Address - Fax:415-986-0491
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-20
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ75342ZMedicaid
CACGP003405OtherCCS GHPP PROVIDER NUMBER
CAZZZ75342ZMedicaid