Individual
DR. DANIELLE JACQUELINE DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5555 GROSSMONT CENTER DR, LA MESA, CA 91942-3019
(619) 740-4401
Mailing address
PO BOX 12170, WESTMINSTER, CA 92685-2170
(877) 818-6102
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
A89796
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A897960
—
CA
01
—
A89796
MEDICAL LICENSE
CA
Enumeration date
05/21/2007
Last updated
05/08/2008
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