Basic Information
| Provider Information | |||||||||
| NPI: | 1669622593 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | VANKIRK | ||||||||
| FirstName: | DALE | ||||||||
| MiddleName: | HERMAN | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3435 RANCHO VISTA CT | ||||||||
| Address2: | |||||||||
| City: | GILROY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 950209412 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4088483255 | ||||||||
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| Practice Location | |||||||||
| Address1: | 401 E CARRILLO ST | ||||||||
| Address2: | |||||||||
| City: | SANTA BARBARA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 931011460 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8055633307 | ||||||||
| FaxNumber: | 8055630998 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/29/2008 | ||||||||
| LastUpdateDate: | 09/29/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | G38376 | CA | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.