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General NPI Number Information
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NPI Number | 1013336544
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Entity Type | Organization
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Legal Business Name | JILBERT DANIEL ISSAI, A PROFESSIONAL MEDICAL CORPORATION
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Dates
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Enumeration Date | 04/13/2014
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Last Update Date | 04/13/2014
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Provider Practice Location Address
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Address Line | 10050 LA CANADA WAY
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City | SUNLAND
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State | CA
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Zip | 91040-1619
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Country | US
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Telephone | 818-437-1744
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Fax |
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Provider Business Mailing Address
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Address Line | 10050 LA CANADA WAY
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City | SUNLAND
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State | CA
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Zip | 91040-1619
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JILBERT DANIEL ISSAI
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Credential |
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Telephone | 818-437-1744
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A75925
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License Number State | CA
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