Daniel James Desurra, L.AC

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AC00826 Issued in OR

Practice address

980 2ND St SE
Bandon, OR 97411-9475

Phone

(541) 347-9100

Fax

(541) 329-0260

NPI assigned

Jan 13, 2007

Last updated

Sep 13, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Well Within

  • Acupuncturist
  • Bandon, OR
  • NPI 1326596933
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473724800000",
    "number": "1851442271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "980 2ND ST SE",
            "city": "BANDON",
            "state": "OR",
            "postal_code": "974119475",
            "telephone_number": "541-347-9100",
            "fax_number": "541-329-0260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "980 2ND ST SE",
            "city": "BANDON",
            "state": "OR",
            "postal_code": "974119475",
            "telephone_number": "541-347-9100",
            "fax_number": "541-329-0260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESURRA",
        "first_name": "DANIEL",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "L.AC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-13",
        "last_updated": "2016-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC00826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Muthalib M Cassim, MD
• Edmund Chaney, PHD
• Canada Converse, RDH, LAP, BA
• Coos County School District 54
• Coos Eye Centers, Inc. (Bandon Vision Center)
• John Dimaggio, DPM
• Susan Lynn Dimock, LCSW
• Anna Delaine Dodd, FNP
• Douglas Medical Equipment Supply (Dba Pacific Sleep Labs)
• Richard Charles Dowling Jr., D.M.D

• Acupuncturist in Bandon, OR
• Providers in Bandon, OR by specialty
• Acupuncturist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.