Healthcare Provider Details

I. General information

NPI: 1780780718
Provider Name (Legal Business Name): DANIEL HOWARD ALCALA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2006
Last Update Date: 08/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10775 FRENCH CREEK RD
PALO CEDRO CA
96073-9527
US

IV. Provider business mailing address

10775 FRENCH CREEK RD
PALO CEDRO CA
96073-9527
US

V. Phone/Fax

Practice location:
  • Phone: 530-243-1134
  • Fax: 530-549-3802
Mailing address:
  • Phone: 530-243-1134
  • Fax: 530-549-3802

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberG38323
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: