Individual
DANIEL DATU BACULI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
38660 LEXINGTON ST APT 588, FREMONT, CA 94536-6201
(498) 261-2801
Mailing address
38660 LEXINGTON ST APT 588, FREMONT, CA 94536-6201
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
11206
CA
Other
Enumeration date
05/14/2020
Last updated
05/14/2020
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