Provider Demographics
NPI:1982705547
Name:DILLINGER, DANIEL L (OD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:L
Last Name:DILLINGER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3211 FORTUNE CT STE A
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95602-9245
Mailing Address - Country:US
Mailing Address - Phone:530-885-6241
Mailing Address - Fax:530-885-0144
Practice Address - Street 1:601 AUBURN FOLSOM RD
Practice Address - Street 2:SUITE A
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95603-5623
Practice Address - Country:US
Practice Address - Phone:530-823-2015
Practice Address - Fax:530-823-2017
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12289 T152W00000X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU99646Medicare UPIN
CAZZZ10958ZMedicare ID - Type UnspecifiedCHAPA-DE'S NUMBER
CATHP12027FMedicaid