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General NPI Number Information
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NPI Number | 1275255572
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Entity Type | Individual
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Provider Name | DANIEL CARDENAS
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Gender | Male
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Dates
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Enumeration Date | 09/13/2022
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Last Update Date | 10/28/2025
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Provider Practice Location Address
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Address Line | 114 W HALL AVE
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City | SAN YSIDRO
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State | CA
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Zip | 92173-2693
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Country | US
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Telephone | 619-980-4291
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Fax |
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Provider Business Mailing Address
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Address Line | 430 F ST
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City | CHULA VISTA
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State | CA
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Zip | 91910-3711
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Country | US
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Telephone | 619-980-4291
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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 | 372600000X
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Taxonomy Name | Adult Companion
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License Number |
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License Number State | CA
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