Healthcare Provider Details

I. General information

NPI: 1770040164
Provider Name (Legal Business Name): DANIEL MAGDY GIRGIS M.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/21/2019
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

780 E GILBERT ST
SAN BERNARDINO CA
92415-1801
US

IV. Provider business mailing address

14074 MANDEVILLE CT
EASTVALE CA
92880-8937
US

V. Phone/Fax

Practice location:
  • Phone: 909-763-4760
  • Fax:
Mailing address:
  • Phone: 951-744-9243
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number140775
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: