Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QA0401X | Family Doctor - Addiction Medicine | DR.0058073 | CO |
NPI | 1558583476 |
---|---|
Provider Name | Dr. Daniel Jason Bebo |
First Address | Cincinnati, OH 45229-2838 |
Second Address | Cincinnati, OH 45229-2838 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2007 |
Last Update Date | 14/03/2021 |