Provider Demographics
NPI:1306895313
Name:MACDANNALD, HARRY J (MD)
Entity type:Individual
Prefix:DR
First Name:HARRY
Middle Name:J
Last Name:MACDANNALD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 LA CASA VIA
Mailing Address - Street 2:BLDG #2, SUITE 208
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-3045
Mailing Address - Country:US
Mailing Address - Phone:925-944-0166
Mailing Address - Fax:
Practice Address - Street 1:130 LA CASA VIA
Practice Address - Street 2:BLDG #2, SUITE 208
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-3045
Practice Address - Country:US
Practice Address - Phone:925-944-0166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG267010207RC0200X
CAG26701207RP1001X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Not Answered207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Not Answered207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G267010Medicaid
CA00G267010Medicare ID - Type Unspecified
CA00G267010Medicaid