Healthcare Provider Details

I. General information

NPI: 1386646180
Provider Name (Legal Business Name): DANIEL W HARWOOD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2005
Last Update Date: 05/31/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 GARDEN GULCH
WEAVERVILLE CA
96093-2280
US

IV. Provider business mailing address

PO BOX 496084
REDDING CA
96049-6084
US

V. Phone/Fax

Practice location:
  • Phone: 530-623-3600
  • Fax: 530-623-1677
Mailing address:
  • Phone: 530-241-0473
  • Fax: 530-229-3703

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberG57785
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: