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General NPI Number Information
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NPI Number | 1396744959
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Entity Type | Individual
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Provider Name | DANIEL JAY TUCKER DPM
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Gender | Male
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Dates
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Enumeration Date | 07/18/2005
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Last Update Date | 07/02/2025
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Provider Practice Location Address
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Address Line | 28078 BAXTER RD STE 424
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City | MURRIETA
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State | CA
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Zip | 92563-1404
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Country | US
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Telephone | 951-679-1020
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 34869
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City | BELFAST
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State | ME
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Zip | 04915-0626
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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 |
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | POD001177
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 25MD00242700
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | N005485
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 00000833
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License Number State | TN
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Taxonomy #5
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | E4705
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License Number State | CA
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