Healthcare Provider Details

I. General information

NPI: 1285624502
Provider Name (Legal Business Name): PATRICK DENNIS DALEY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2005
Last Update Date: 06/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3008 SILLECT AVE SUITE 240
BAKERSFIELD CA
93308-6340
US

IV. Provider business mailing address

3008 SILLECT AVE SUITE 240
BAKERSFIELD CA
93308-6340
US

V. Phone/Fax

Practice location:
  • Phone: 661-616-9300
  • Fax: 661-616-9301
Mailing address:
  • Phone: 661-616-9300
  • Fax: 661-616-9301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberG34597
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License NumberG34597
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: