Healthcare Provider Details

I. General information

NPI: 1972298040
Provider Name (Legal Business Name): DANIEL HARWOOD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2023
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 THE CITY DR S
ORANGE CA
92868-3201
US

IV. Provider business mailing address

24902 VIA SANTA CRUZ
MISSION VIEJO CA
92692-2437
US

V. Phone/Fax

Practice location:
  • Phone: 914-844-0215
  • Fax:
Mailing address:
  • Phone: 914-844-0215
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA208715
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: