Individual
MR. MICHEAL T DANIELS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3265 ADAMS AVE APT 31, SAN DIEGO, CA 92116-1649
(760) 508-9540
Mailing address
3265 ADAMS AVE APT 31, SAN DIEGO, CA 92116-1649
(760) 508-9540
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
00796237
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
228226
OPEN
—
05
—
228226
—
CA
Enumeration date
04/11/2016
Last updated
01/14/2018
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