Basic Information
| Provider Information | |||||||||
| NPI: | 1952305914 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | IGWE | ||||||||
| FirstName: | DANIEL | ||||||||
| MiddleName: | |||||||||
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| NameSuffix: | JR. | ||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1225 E LATHAM AVE | ||||||||
| Address2: | #A | ||||||||
| City: | HEMET | ||||||||
| State: | CA | ||||||||
| PostalCode: | 925434423 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9519296260 | ||||||||
| FaxNumber: | 9517652855 | ||||||||
| Practice Location | |||||||||
| Address1: | 2390 E FLORIDA AVE | ||||||||
| Address2: | #103 | ||||||||
| City: | HEMET | ||||||||
| State: | CA | ||||||||
| PostalCode: | 925444707 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9517660374 | ||||||||
| FaxNumber: | 9517660601 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/08/2005 | ||||||||
| LastUpdateDate: | 11/02/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 2002-0051 | NM | Y | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.