Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | G64208 | CA |
NPI | 1013005503 |
---|---|
Provider Name | Dr. Daniel Kwan Dea |
First Address | Burbank, CA 91505-4402 |
Second Address | Burbank, CA 91505-4402 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2006 |
Last Update Date | 12/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F63987 | (02) | CA |