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General NPI Number Information
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NPI Number | 1407487457
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Entity Type | Organization
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Legal Business Name | DANIEL GAITAN HEALTHCARE, INC
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Dates
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Enumeration Date | 01/29/2020
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Last Update Date | 03/01/2021
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Provider Practice Location Address
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Address Line | 425 N NEW BALLAS RD STE 107
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City | SAINT LOUIS
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State | MO
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Zip | 63141-6845
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Country | US
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Telephone | 314-432-2592
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Fax | 314-432-2595
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Provider Business Mailing Address
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Address Line | 425 N NEW BALLAS RD STE 107
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City | SAINT LOUIS
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State | MO
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Zip | 63141-6845
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Country | US
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Telephone | 314-432-2592
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. DANIEL GAITAN
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Credential |
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Telephone | 314-498-1977
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number |
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License Number State |
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