Provider Demographics
NPI:1265433254
Name:BIRKBECK, DANIEL P (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:P
Last Name:BIRKBECK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3273 CLAREMONT WAY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-3306
Mailing Address - Country:US
Mailing Address - Phone:707-254-7117
Mailing Address - Fax:707-265-6435
Practice Address - Street 1:3273 CLAREMONT WAY
Practice Address - Street 2:SUITE 100
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558-3306
Practice Address - Country:US
Practice Address - Phone:707-254-7117
Practice Address - Fax:707-265-6435
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG86952207XS0106X
MIDB055806207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIDB055806OtherBCBS LICENSE
MIP92231OtherBLUE CARE NETWORK
MI5438181OtherAETNA
MI32697515Medicaid
G38164Medicare UPIN
MI32697515Medicaid