Provider Demographics
NPI:1144436874
Name:PLANCE, DAVID W
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:W
Last Name:PLANCE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10282 CLAMAGORO CIR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92124-3645
Mailing Address - Country:US
Mailing Address - Phone:858-573-8969
Mailing Address - Fax:
Practice Address - Street 1:USS LAKE CHAMPLAIN (CG 57)
Practice Address - Street 2:
Practice Address - City:FPO
Practice Address - State:UNITED STATES
Practice Address - Zip Code:AP
Practice Address - Country:US
Practice Address - Phone:619-556-4494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman