Healthcare Provider Details

I. General information

NPI: 1134048887
Provider Name (Legal Business Name): DANIEL SON
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5832 BEACH BLVD STE 114
BUENA PARK CA
90621-2010
US

IV. Provider business mailing address

5832 BEACH BLVD STE 114
BUENA PARK CA
90621-2010
US

V. Phone/Fax

Practice location:
  • Phone: 714-707-2699
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number310384
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: