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NPI Code Detail

MEDICARE: DANIEL SOLOMON AGEZE

MEDICARE: DANIEL SOLOMON AGEZE
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
1207Q00000XFamily Medicine Physician0101268845VA
2207QA0401XAddiction Medicine (Family Medicine) Physician0101268845VA
32083A0300XAddiction Medicine (Preventive Medicine) PhysicianA181897CA

General Provider Information

NPI Number : 1922531524
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIEL SOLOMON AGEZE
Provider Business Mailing Address
First Line : 550 W WASHINGTON AVE
Second Line :
City : ESCONDIDO
State : CA
Zip : 92025-1643
Country : US
Telephone Number : 833-867-4642
Fax Number :
Provider Business Practice Location Address
First Line : 550 W WASHINGTON AVE
Second Line :
City : ESCONDIDO
State : CA
Zip : 92025-1643
Country : US
Telephone Number : 833-867-4642
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2017
Last Update Date : 01/20/2024

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