Provider Demographics
NPI:1093051385
Name:HALE, DANA L (PA)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:L
Last Name:HALE
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:29995 TECHNOLOGY DR STE 201
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-2633
Mailing Address - Country:US
Mailing Address - Phone:951-696-2215
Mailing Address - Fax:951-696-2286
Practice Address - Street 1:29995 TECHNOLOGY DR STE 201
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-2633
Practice Address - Country:US
Practice Address - Phone:951-696-2215
Practice Address - Fax:951-696-2286
Is Sole Proprietor?:No
Enumeration Date:2012-12-14
Last Update Date:2012-12-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPA11347363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical