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Individual

DANIEL ALLEN LOGAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1660 HOTEL CIR N STE 314, SAN DIEGO, CA 92108-2803
(619) 961-2120
Mailing address
1660 HOTEL CIR N STE 314, SAN DIEGO, CA 92108-2803
(619) 961-2120

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
CA
175T00000X
Peer Specialist
Primary
CA

Other

Enumeration date
05/30/2024
Last updated
04/16/2025
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