Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | A43309 | CA |
NPI | 1013063957 |
---|---|
Provider Name | Edmee Marguerite Danan |
First Address | Sebastopol, CA 95472-3164 |
Second Address | Santa Rosa, CA 95401-4606 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/01/2007 |
Last Update Date | 07/08/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A433090 | (05) | CA |
E25255 | (02) | CA |