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Individual

MR. DANIEL BENJAMIN GRAVILONI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RCP

Contact information

Practice address
101 E VALENCIA MESA DR, FULLERTON, CA 92835-3809
(714) 992-3000
Mailing address
101 E VALENCIA MESA DR, FULLERTON, CA 92835-3809
(714) 992-3000

Taxonomy

Speciality
Code
Description
License number
State
227900000X
Registered Respiratory Therapist
19033
CA
2279P3900X
Neonatal/Pediatric Registered Respiratory Therapist
Primary
19033
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
19033
RCB
CA
Enumeration date
03/19/2019
Last updated
03/19/2019
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