Provider Demographics
NPI:1841353869
Name:VASILE, DAN (DO)
Entity type:Individual
Prefix:DR
First Name:DAN
Middle Name:
Last Name:VASILE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18522 US HIGHWAY 18 STE 102
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92307-2321
Mailing Address - Country:US
Mailing Address - Phone:760-242-7707
Mailing Address - Fax:760-242-1133
Practice Address - Street 1:18522 US HIGHWAY 18 STE 102
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92307-2321
Practice Address - Country:US
Practice Address - Phone:760-242-7707
Practice Address - Fax:760-242-1133
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2018-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A6930207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1841353869Medicaid
CA651204047OtherTAX ID
CA651204047OtherTAX ID