Healthcare Provider Details

I. General information

NPI: 1962673046
Provider Name (Legal Business Name): DANIEL YOUNG PAIK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/18/2008
Last Update Date: 02/04/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1455 MONTEGO SUITE 100
WALNUT CREEK CA
94598-2990
US

IV. Provider business mailing address

1455 MONTEGO SUITE 100
WALNUT CREEK CA
94598-2990
US

V. Phone/Fax

Practice location:
  • Phone: 925-627-3440
  • Fax: 925-627-3450
Mailing address:
  • Phone: 925-627-3440
  • Fax: 925-627-3450

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License NumberA116295
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: