Healthcare Provider Details

I. General information

NPI: 1992265425
Provider Name (Legal Business Name): RACHEL DANIELL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2019
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2841 RENDOVA RD
SAN DIEGO CA
92155-5490
US

IV. Provider business mailing address

522 VIA DE LA VALLE UNIT J
SOLANA BEACH CA
92075-2476
US

V. Phone/Fax

Practice location:
  • Phone: 678-939-5227
  • Fax:
Mailing address:
  • Phone: 678-939-5227
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number87762
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number87762
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: