Healthcare Provider Details

I. General information

NPI: 1912894056
Provider Name (Legal Business Name): DANIELA ELIZABETH OBREGON
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2025
Last Update Date: 06/20/2025
Certification Date: 06/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

VELEZ SARSFIELD 300
SALSIPUEDES CORDOBA
X5113
AR

IV. Provider business mailing address

16501 VENTURA BLVD STE 400
ENCINO CA
91436-2067
US

V. Phone/Fax

Practice location:
  • Phone: 354-365-8353
  • Fax:
Mailing address:
  • Phone: 818-935-6273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171R00000X
TaxonomyInterpreter
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: