MEDICARE: DANIEL BROIN

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	104100000X	Social Worker

General Provider Information

NPI Number	:	1952593626
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL BROIN

Provider Business Mailing Address
First Line	:	1685 DOLORES ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94110-4924
Country	:	US
Telephone Number	:	415-215-6655
Fax Number	:

Provider Business Practice Location Address
First Line	:	1191 CENTRAL BLVD
Second Line	:
City	:	BRENTWOOD
State	:	CA
Zip	:	94513-2279
Country	:	US
Telephone Number	:	925-634-4445
Fax Number	:

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

Provider Enumeration Date	:	08/15/2007
Last Update Date	:	08/15/2007

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Directions to “ DANIEL BROIN ” Practice Location

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