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General NPI Number Information
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NPI Number | 1477178200
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Entity Type | Individual
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Provider Name | DANHILL JOSEPH PANGILINAN VIRGO
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Gender | Male
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Dates
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Enumeration Date | 06/08/2020
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Last Update Date | 02/08/2024
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Provider Practice Location Address
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Address Line | 4371 LATHAM ST
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City | RIVERSIDE
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State | CA
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Zip | 92501-1706
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Country | US
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Telephone | 833-867-4642
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Fax |
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Provider Business Mailing Address
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Address Line | 338 S DAKOTA AVE
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City | VANDENBERG AFB
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State | CA
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Zip | 93437-6307
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 57993
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License Number State | CA
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