| Organization Name: | DAUDEL PROFESSIONAL MEDICAL CORPORATION |
| NPI Number: | 1194052100 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | J. LINN DAUDEL (OWNER) |
| Mailing Address: | 1100 Rose Dr Ste 140 Benicia |
| State: | CA US |
| Postal Code: | 945103623 |
| Phone Number: | 7077453700 |
| Fax Number: | |
| NPI Enumeration Date: | 11/11/2009 |
| NPI Last Update Date: | 11/11/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207VX0000X |
| License Number: | A95421 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Obstetrics & Gynecology |
| Taxonomy Specialization: | Obstetrics |
| Taxonomy Definition: | |