Healthcare Provider Details

I. General information

NPI: 1386135481
Provider Name (Legal Business Name): DANIEL ANIBAL ORELLANA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2018
Last Update Date: 07/18/2024
Certification Date: 07/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9300 VALLEY CHILDRENS PL # SC05
MADERA CA
93636-8762
US

IV. Provider business mailing address

9300 VALLEY CHILDRENS PL # SC05
MADERA CA
93636-8762
US

V. Phone/Fax

Practice location:
  • Phone: 559-353-5700
  • Fax: 559-353-5708
Mailing address:
  • Phone: 559-353-5700
  • Fax: 559-353-5708

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License NumberA164891
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: