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General NPI Number Information
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NPI Number | 1598575003
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Entity Type | Organization
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Legal Business Name | ITANO AND ASSOCIATES PLLC
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Dates
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Enumeration Date | 01/08/2025
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Last Update Date | 01/08/2025
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Provider Practice Location Address
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Address Line | 1081 KATHLEEN AVE
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City | KINGMAN
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State | AZ
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Zip | 86401-3918
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Country | US
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Telephone | 928-753-5580
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Fax |
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Provider Business Mailing Address
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Address Line | 1550 W HORIZON RIDGE PKWY STE PMB 35
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City | HENDERSON
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State | NV
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Zip | 89012-3600
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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 | OWNER AND PROVIDER
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Name | DANIEL ITANO
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Credential | DO
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Telephone | 714-458-8875
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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 |
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License Number State |
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