Individual
DR. DANIEL CARBALLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3955 PARKLAWN AVE STE 120, EDINA, MN 55435-5660
(952) 278-6950
(952) 278-6947
Mailing address
3955 PARKLAWN AVE STE 120, EDINA, MN 55435-5660
(952) 278-6950
(952) 278-6947
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
59095
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/22/2012
Last updated
08/12/2015
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