Provider Demographics
NPI:1871657601
Name:DORRANCE, DAVID LADD (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:LADD
Last Name:DORRANCE
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 1:2940 WHIPPLE AVE
Mailing Address - Street 2:STE. C.
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94062-2857
Mailing Address - Country:US
Mailing Address - Phone:650-369-1766
Mailing Address - Fax:
Practice Address - Street 1:2940 WHIPPLE AVE
Practice Address - Street 2:STE. C.
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94062-2857
Practice Address - Country:US
Practice Address - Phone:650-369-1766
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG19741207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G197410Medicare ID - Type UnspecifiedMEDICARE ID NUMBER