Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | G62652 | CA |
NPI | 1013916733 |
---|---|
Provider Name | Daniel J Buckley |
First Address | Daly City, CA 94015-2224 |
Second Address | Daly City, CA 94015-2224 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2005 |
Last Update Date | 31/01/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B64226 | (02) | CA |
GR0066060 | (05) | CA |