Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | A150973 | CA |
NPI | 1003263963 |
---|---|
Provider Name | Dr. Daniel Samano |
First Address | Los Angeles, CA 90074-4701 |
Second Address | Loma Linda, CA 92354-3130 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2016 |
Last Update Date | 19/07/2019 |