Basic Information
| Provider Information | |||||||||
| NPI: | 1447391693 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ENG | ||||||||
| FirstName: | DANIEL | ||||||||
| MiddleName: | K | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | O.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8227 DAY CREEK BLVD STE 100 | ||||||||
| Address2: | |||||||||
| City: | RANCHO CUCAMONGA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917398568 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9098990245 | ||||||||
| FaxNumber: | 9098991293 | ||||||||
| Practice Location | |||||||||
| Address1: | 34500 MONTEREY AVE | ||||||||
| Address2: | |||||||||
| City: | PALM DESERT | ||||||||
| State: | CA | ||||||||
| PostalCode: | 922112089 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7603218124 | ||||||||
| FaxNumber: | 7603241069 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/09/2007 | ||||||||
| LastUpdateDate: | 06/10/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | 8712T | CA | Y | Eye and Vision Services Providers | Optometrist |
No ID Information.