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General NPI Number Information
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NPI Number | 1285279083
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Entity Type | Individual
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Provider Name | DANNY F. SAN MIGUEL SUPPLIER
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Gender | Male
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Dates
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Enumeration Date | 11/15/2019
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Last Update Date | 11/15/2019
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Provider Practice Location Address
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Address Line | 9607 BUSINESS CENTER DR UNIT E
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-4557
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Country | US
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Telephone | 909-225-0774
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Fax | 909-941-7186
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Provider Business Mailing Address
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Address Line | 9331 MAJESTY DR
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-2638
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Country | US
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Telephone | 909-225-0774
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Fax | 909-941-7186
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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 | 332BN1400X
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Taxonomy Name | Nursing Facility Supplies (DME)
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License Number |
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License Number State |
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