Basic Information
| Provider Information | |||||||||
| NPI: | 1780620419 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HEALY | ||||||||
| FirstName: | DANIEL | ||||||||
| MiddleName: | J. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1430 | ||||||||
| Address2: | |||||||||
| City: | MONROVIA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 910171430 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6262566010 | ||||||||
| FaxNumber: | 6262566070 | ||||||||
| Practice Location | |||||||||
| Address1: | 1755 HUNTINGTON DR | ||||||||
| Address2: | STE#104 | ||||||||
| City: | DUARTE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 910102567 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6263034651 | ||||||||
| FaxNumber: | 6263580915 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/21/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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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 | 207Q00000X | G45341 | CA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.