Healthcare Provider Details

I. General information

NPI: 1265054191
Provider Name (Legal Business Name): DANIELLE ANGELICA LUZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/13/2020
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

453 QUARRY RD
PALO ALTO CA
94304-1419
US

IV. Provider business mailing address

453 QUARRY RD
PALO ALTO CA
94304-1419
US

V. Phone/Fax

Practice location:
  • Phone: 650-721-5804
  • Fax:
Mailing address:
  • Phone: 650-721-5804
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number1265054191
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number125076301
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: