Healthcare Provider Details

I. General information

NPI: 1669671681
Provider Name (Legal Business Name): DANIEL LEE OUYANG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2007
Last Update Date: 12/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2734 EL CAMINO REAL
SANTA CLARA CA
95051-3007
US

IV. Provider business mailing address

2350 W EL CAMINO REAL 2ND FLOOR
MOUNTAIN VIEW CA
94040-6201
US

V. Phone/Fax

Practice location:
  • Phone: 408-241-3801
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RS0010X
TaxonomySports Medicine (Internal Medicine) Physician
License NumberA92727
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: