Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | DC25985 | CA |
NPI | 1437378551 |
---|---|
Provider Name | Chris Mcdaniel |
First Address | San Luis Obispo, CA 93401-3909 |
Second Address | San Luis Obispo, CA 93401-3909 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2007 |
Last Update Date | 08/07/2007 |