Healthcare Provider Details

I. General information

NPI: 1205830684
Provider Name (Legal Business Name): DANIEL J. PARA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2005
Last Update Date: 06/27/2022
Certification Date: 06/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9515 W CAMELBACK RD SUITE 132
PHOENIX AZ
85037-1355
US

IV. Provider business mailing address

9515 W CAMELBACK RD SUITE 132
PHOENIX AZ
85037-1355
US

V. Phone/Fax

Practice location:
  • Phone: 623-247-4900
  • Fax: 623-247-4908
Mailing address:
  • Phone: 623-247-4900
  • Fax: 623-247-4908

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberE-15280
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number022450
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: