Individual
DAN C IM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
18300 ROSCOE BLVD, NORTHRIDGE, CA 91325-4105
(818) 885-8500
Mailing address
18300 ROSCOE BLVD, NORTHRIDGE, CA 91325-4105
(818) 885-8500
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
A181359
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/28/2017
Last updated
06/28/2025
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