Individual
DANNY LINGGONEGORO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
450 BROADWAY ST FL C2, REDWOOD CITY, CA 94063-3132
(650) 721-7190
Mailing address
450 BROADWAY ST FL C2, REDWOOD CITY, CA 94063-3132
(650) 721-7190
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
A191221
CA
208000000X
Pediatrics Physician
293781
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/31/2022
Last updated
04/12/2024
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