IndividualActive
Dane Weatherford, IDC
NPI 1053686824 · Military Health Care Provider · San Diego, CA
Provider details
- NPI number
- 1053686824
- Entity type
- Individual
- Primary specialty
- Military Health Care ProviderOther Service Providers
- Credential
- IDC
- Sex
- Male
- Sole proprietor
- Yes
Specialties & taxonomies
Other Service Providers
Practice location
10209 Hooper St
San Diego, CA 92124-3509
Phone: (860) 501-0511
Approximate (ZIP-level) locationGet directions
Mailing address
10209 Hooper St
San Diego, CA 92124-3509
Registry dates
- Enumerated
- 2012-03-13
- Last updated
- 2012-03-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.