Healthcare Provider Details

I. General information

NPI: 1578618583
Provider Name (Legal Business Name): DANIEL GELLER DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 06/04/2025
Certification Date: 06/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32144 AGOURA RD STE 118
WESTLAKE VILLAGE CA
91361-4046
US

IV. Provider business mailing address

330 W 58TH ST STE 407
NEW YORK NY
10019-1820
US

V. Phone/Fax

Practice location:
  • Phone: 818-584-8223
  • Fax: 866-514-9528
Mailing address:
  • Phone: 917-546-9070
  • Fax: 866-514-9528

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberN005892-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberSC007319
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberE4706
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: