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General NPI Number Information
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NPI Number | 1639409741
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Entity Type | Organization
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Legal Business Name | DANIEL V. SHALOM
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Dates
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Enumeration Date | 01/12/2010
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Last Update Date | 01/12/2010
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Provider Practice Location Address
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Address Line | 909 HYDE ST STE 124
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City | SAN FRANCISCO
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State | CA
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Zip | 94109-4832
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Country | US
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Telephone | 415-567-1956
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Fax |
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Provider Business Mailing Address
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Address Line | 909 HYDE ST STE 124
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City | SAN FRANCISCO
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State | CA
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Zip | 94109-4832
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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 | OFFICE MANAGER
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Name | CHAD DAVIS
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Credential |
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Telephone | 415-567-1956
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | G61002
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License Number State | CA
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