Healthcare Provider Details

I. General information

NPI: 1649781568
Provider Name (Legal Business Name): DANIEL B LYMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/18/2017
Last Update Date: 10/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46-E PENINSULA CENTER DR. #394
ROLLING HILLS ESTATES CA
90274
US

IV. Provider business mailing address

46-E PENINSULA CENTER DR. #394
ROLLING HILLS ESTATES CA
90274
US

V. Phone/Fax

Practice location:
  • Phone: 303-437-2975
  • Fax:
Mailing address:
  • Phone: 303-437-2975
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number17818
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: