Provider Demographics
NPI:1174565303
Name:FOREMAN, DANIEL STUART (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:STUART
Last Name:FOREMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3126 PROFESSIONAL DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95603-2410
Mailing Address - Country:US
Mailing Address - Phone:530-885-3767
Mailing Address - Fax:530-885-3201
Practice Address - Street 1:3126 PROFESSIONAL DR
Practice Address - Street 2:SUITE 300
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95603-2410
Practice Address - Country:US
Practice Address - Phone:530-885-3767
Practice Address - Fax:530-885-3201
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-12
Last Update Date:2011-11-16
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Provider Licenses
StateLicense IDTaxonomies
CAA45204207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ21772ZMedicare PIN
CAF11433Medicare UPIN
CA1309430001Medicare NSC
CA00A452040Medicare PIN
CADG683AMedicare PIN