Healthcare Provider Details

I. General information

NPI: 1326208430
Provider Name (Legal Business Name): DANIELLE AUFIERO MD MEDICAL GROUP INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2008
Last Update Date: 02/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10780 SANTA MONICA BLVD SUITE 210
LOS ANGELES CA
90025-4749
US

IV. Provider business mailing address

10780 SANTA MONICA BLVD STE 210
LOS ANGELES CA
90025-4749
US

V. Phone/Fax

Practice location:
  • Phone: 310-453-5404
  • Fax:
Mailing address:
  • Phone: 310-453-5404
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberA86231
License Number StateCA

VIII. Authorized Official

Name: DANIELLE C AUFIERO
Title or Position: PRESIDENT
Credential: MD
Phone: 310-453-5404