Healthcare Provider Details

I. General information

NPI: 1912944232
Provider Name (Legal Business Name): DANIEL S PATRICK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 12/17/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1303 E HERNDON AVE SUITE 200
FRESNO CA
93720-3309
US

IV. Provider business mailing address

PO BOX 6102
NOVATO CA
94948-6102
US

V. Phone/Fax

Practice location:
  • Phone: 559-450-3109
  • Fax: 559-450-3674
Mailing address:
  • Phone: 415-884-3404
  • Fax: 415-883-1836

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207UN0902X
TaxonomyNuclear Imaging & Therapy Physician
License NumberA92101
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: