Individual
DANIEL ITANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
101 CIVIC CENTER LN, LAKE HAVASU CITY, AZ 86403-5607
(928) 855-8185
Mailing address
5870 HIATUS RD, TAMARAC, FL 33321-6424
(888) 447-2362
(865) 560-7110
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
008447
AZ
207Q00000X
Family Medicine Physician
20A13692
CA
207Q00000X
Family Medicine Physician
Primary
DO2126
NV
Other
Enumeration date
07/23/2014
Last updated
01/28/2025
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