Individual
DANIEL TAHERI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10884 SANTA MONICA BLVD, 3RD FLOOR, LOS ANGELES, CA 90025-4646
(310) 446-4400
(310) 446-4408
Mailing address
2409 ARTESIA BLVD FL 2, REDONDO BEACH, CA 90278-3207
(424) 276-4700
(424) 903-1099
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
G80445
CA
207ND0101X
MOHS-Micrographic Surgery Physician
G80445
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11900
NEVADA MEDICAL LICENSE
NV
01
—
37910
ARIZONA MEDICAL LICENSE
AZ
01
—
G80445
CALIFORNIA MEDICAL LICENSE
CA
Enumeration date
03/15/2006
Last updated
03/17/2018
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