Healthcare Provider Details

I. General information

NPI: 1932173291
Provider Name (Legal Business Name): MICHAEL SEAN DANFORTH D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2006
Last Update Date: 03/05/2025
Certification Date: 03/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 MERCY CIRCLE
OCEANSIDE CA
92055-5191
US

IV. Provider business mailing address

200 MERCY CIRCLE
OCEANSIDE CA
92055
US

V. Phone/Fax

Practice location:
  • Phone: 760-719-3583
  • Fax: 760-725-1101
Mailing address:
  • Phone: 760-719-3683
  • Fax: 760-725-1101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20A7138
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: