Healthcare Provider Details

I. General information

NPI: 1831115237
Provider Name (Legal Business Name): DAVID J HERFINDAHL M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2006
Last Update Date: 11/05/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 S MAIN ST STE 1
YREKA CA
96097-3354
US

IV. Provider business mailing address

PO BOX 1608
YREKA CA
96097-1608
US

V. Phone/Fax

Practice location:
  • Phone: 530-842-0817
  • Fax: 530-842-4907
Mailing address:
  • Phone: 530-842-0817
  • Fax: 530-842-4907

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA25420
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: