Healthcare Provider Details

I. General information

NPI: 1639130404
Provider Name (Legal Business Name): DANNY M HALL D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/31/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MANNHEIM HEALTH CLINIC BEN FRANKLIN VILLAGE UNIT 29920
APO AE
09086
DE

IV. Provider business mailing address

ATTN: CREDENTIALS OFFICE CMR 442
APO AE
09042
DE

V. Phone/Fax

Practice location:
  • Phone: 4906217301750
  • Fax: 4906217304665
Mailing address:
  • Phone: 496221172274
  • Fax: 496221172941

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20A6137
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberL2918
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: