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General NPI Number Information
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NPI Number | 1255292744
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Entity Type | Individual
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Provider Name | DANIEL RAY MICRO JR.
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Gender | Male
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Dates
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Enumeration Date | 11/24/2025
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Last Update Date | 11/24/2025
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Provider Practice Location Address
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Address Line | 7344 MAGNOLIA AVE STE 130
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City | RIVERSIDE
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State | CA
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Zip | 92504-3819
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Country | US
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Telephone | 951-404-0856
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Fax |
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Provider Business Mailing Address
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Address Line | 8008 MAGNOLIA AVE APT 20
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City | RIVERSIDE
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State | CA
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Zip | 92504-3450
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Country | US
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Telephone | 951-404-0856
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State | CA
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