Individual
DALI FAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4860 Y ST STE 2820, SACRAMENTO, CA 95817-2307
(916) 734-5191
(916) 734-8394
Mailing address
4860 Y ST STE 2820, SACRAMENTO, CA 95817-2307
(916) 734-5191
(916) 734-8394
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
216542
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02553322
—
NY
Enumeration date
05/06/2006
Last updated
10/28/2011
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