Provider Demographics
NPI:1811438120
Name:BEMPORAD, DANIEL JULES (DO)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:JULES
Last Name:BEMPORAD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 300
Mailing Address - Street 2:
Mailing Address - City:WARM SPRINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59756-0300
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100 GARNET WAY
Practice Address - Street 2:
Practice Address - City:WARM SPRINGS
Practice Address - State:MT
Practice Address - Zip Code:59756-9705
Practice Address - Country:US
Practice Address - Phone:406-693-7000
Practice Address - Fax:406-693-7069
Is Sole Proprietor?:No
Enumeration Date:2017-03-20
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT994962084P0800X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program