MEDICARE: DR. DANIEL FENG PHARM.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	54152	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	54152	OTHER	CA	LICENSE NUMBER

General Provider Information

NPI Number	:	1649381831
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL FENG PHARM.D.

Provider Business Mailing Address
First Line	:	1717 E WALNUT ST
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91106-1611
Country	:	US
Telephone Number	:	626-798-6789
Fax Number	:	626-798-8376

Provider Business Practice Location Address
First Line	:	1717 E WALNUT ST
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91106-1611
Country	:	US
Telephone Number	:	626-798-6789
Fax Number	:	626-798-8376

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	03/14/2017

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