Provider Demographics
NPI:1154373264
Name:HEER, DALE (DC)
Entity type:Individual
Prefix:DR
First Name:DALE
Middle Name:
Last Name:HEER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:551 FOSTER CITY BLVD
Mailing Address - Street 2:SUITE C
Mailing Address - City:FOSTER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94404-1687
Mailing Address - Country:US
Mailing Address - Phone:650-573-9371
Mailing Address - Fax:650-573-1343
Practice Address - Street 1:551 FOSTER CITY BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:FOSTER CITY
Practice Address - State:CA
Practice Address - Zip Code:94404-1687
Practice Address - Country:US
Practice Address - Phone:650-573-9371
Practice Address - Fax:650-573-1343
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC0230150111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA350037411OtherMEDICARE RAILROAD
CA350037411OtherMEDICARE RAILROAD
U51825Medicare UPIN