Healthcare Provider Details

I. General information

NPI: 1215121173
Provider Name (Legal Business Name): DANIELLE RODIN FLOWERS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MISS DANIELLE LISA RODIN

II. Dates (important events)

Enumeration Date: 09/04/2007
Last Update Date: 11/01/2021
Certification Date: 11/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13652 CANTARA ST SOUTH 1- 107A
PANORAMA CITY CA
91402-5423
US

IV. Provider business mailing address

20849 VERCELLI WAY
PORTER RANCH CA
91326-4309
US

V. Phone/Fax

Practice location:
  • Phone: 818-375-2809
  • Fax:
Mailing address:
  • Phone: 818-700-2636
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA88202
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: