Provider Demographics
NPI:1942318134
Name:PLANCE, DONALD WAYNE (DO)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:WAYNE
Last Name:PLANCE
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:2520 HONOLULU AVE
Mailing Address - Street 2:STE 170
Mailing Address - City:MONTROSE
Mailing Address - State:CA
Mailing Address - Zip Code:91020-1853
Mailing Address - Country:US
Mailing Address - Phone:818-249-4134
Mailing Address - Fax:818-249-9523
Practice Address - Street 1:2520 HONOLULU AVE
Practice Address - Street 2:STE 170
Practice Address - City:MONTROSE
Practice Address - State:CA
Practice Address - Zip Code:91020-1853
Practice Address - Country:US
Practice Address - Phone:818-249-4134
Practice Address - Fax:818-249-9523
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2016-12-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA20A5465207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00AX54650Medicare ID - Type Unspecified
E04686Medicare UPIN