Basic Information
| Provider Information | |||||||||
| NPI: | 1619397551 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DANIELS | ||||||||
| FirstName: | MORGAINE | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11234 ANDERSON ST | ||||||||
| Address2: | GME OFFICE WESTERLY SUITE 'C' | ||||||||
| City: | LOMA LINDA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 923542804 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9095584085 | ||||||||
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| Practice Location | |||||||||
| Address1: | COTTAGE HOSPITAL, DEPT OF EMERGENCY MEDICINE | ||||||||
| Address2: | 400 WEST PUEBLO STREET | ||||||||
| City: | SANTA BARBARA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 93105 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8056827111 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/18/2014 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | A138985 | CA | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | A137985 | CA | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.