Healthcare Provider Details

I. General information

NPI: 1326417916
Provider Name (Legal Business Name): DANIEL ANGELI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/24/2015
Last Update Date: 04/05/2022
Certification Date: 04/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1498 SOUTHGATE AVE STE 102
DALY CITY CA
94015-4015
US

IV. Provider business mailing address

2149 E WARNER RD STE 102
TEMPE AZ
85284-3495
US

V. Phone/Fax

Practice location:
  • Phone: 650-755-4490
  • Fax:
Mailing address:
  • Phone: 480-610-6100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25MA10309200
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberA168749
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: