Organization Name: | SUSAN M. DANEK MD A PROFESSIONAL MEDICAL CORPORATION |
NPI Number: | 1033307277 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SUSAN M. DANEK (PRESIDENT) |
Mailing Address: | 29798 Haun Rd Suite 302 Sun City |
State: | CA US |
Postal Code: | 925866541 |
Phone Number: | 9513017191 |
Fax Number: | 9513014160 |
NPI Enumeration Date: | 10/12/2007 |
NPI Last Update Date: | 10/12/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2300X |
License Number: | G080713 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |