Healthcare Provider Details

I. General information

NPI: 1740777606
Provider Name (Legal Business Name): DANIEL JOSEPH MINTER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2018
Last Update Date: 11/21/2023
Certification Date: 11/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 PARNASSUS AVE
SAN FRANCISCO CA
94143-2203
US

IV. Provider business mailing address

513 PARNASSUS AVE FL 3
SAN FRANCISCO CA
94143-2205
US

V. Phone/Fax

Practice location:
  • Phone: 888-689-8273
  • Fax:
Mailing address:
  • Phone: 415-476-9362
  • Fax: 415-353-3538

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberA166540
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: