Healthcare Provider Details

I. General information

NPI: 1053353763
Provider Name (Legal Business Name): DAISY MAE CABALQUINTO MARKLEY MD.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2006
Last Update Date: 03/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27924 SECO CANYON RD
SANTA CLARITA CA
91350-3870
US

IV. Provider business mailing address

PO BOX 9602
MISSION HILLS CA
91346-9602
US

V. Phone/Fax

Practice location:
  • Phone: 661-513-2100
  • Fax: 661-513-2105
Mailing address:
  • Phone: 818-837-5691
  • Fax: 818-792-4793

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA71718
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: