Basic Information
| Provider Information | |||||||||
| NPI: | 1245499060 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HERMAN | ||||||||
| FirstName: | DANIEL | ||||||||
| MiddleName: | C | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD, PHD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4860 Y ST. STE 3850 | ||||||||
| Address2: | DEPARTMENT OF PHYSICAL MEDICINE AND REHABILITATION | ||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958170001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9167347041 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3301 C ST STE 1600 | ||||||||
| Address2: | |||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958163384 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9167346805 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/06/2008 | ||||||||
| LastUpdateDate: | 10/28/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/08/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2081S0010X | ME116759 | FL | N | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Sports Medicine | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 2081S0010X | 174837 | CA | Y | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Sports Medicine |
ID Information
| ID | Type | State | Issuer | Description | 009092700 | 05 | FL | MEDICAID |