Individual
DANIEL R JIMENEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2720 STONE PARK BLVD, SIOUX CITY, IA 51104-3734
(712) 279-3789
(712) 279-3613
Mailing address
2720 STONE PARK BLVD, SIOUX CITY, IA 51104-3734
(712) 279-3789
(712) 279-3613
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
21344
IA
208000000X
Pediatrics Physician
21344
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00142603
RR MEDICARE NUMBER
IA
Enumeration date
03/31/2006
Last updated
02/19/2008
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