Provider Demographics
NPI:1588772578
Name:DANA R. VERCH, M.D.,INC
Entity type:Organization
Organization Name:DANA R. VERCH, M.D.,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHOPAEDIC SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:DANA
Authorized Official - Middle Name:R
Authorized Official - Last Name:VERCH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:530-823-9350
Mailing Address - Street 1:11720 EDUCATION ST STE 1
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95602-2419
Mailing Address - Country:US
Mailing Address - Phone:530-823-9350
Mailing Address - Fax:530-823-9221
Practice Address - Street 1:11720 EDUCATION ST STE 1
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95602-2419
Practice Address - Country:US
Practice Address - Phone:530-823-9350
Practice Address - Fax:530-823-9221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG76299174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG76299Medicaid
CAF30483Medicare UPIN
CAG76299Medicaid