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General NPI Number Information
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NPI Number | 1730132606
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Entity Type | Individual
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Provider Name | DAISY NICANOR DEMARANVILLE MD
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Gender | Female
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Dates
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Enumeration Date | 05/19/2006
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Last Update Date | 08/31/2018
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Provider Practice Location Address
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Address Line | 26501 AVENUE 140
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City | PORTERVILLE
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State | CA
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Zip | 93257
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Country | US
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Telephone | 559-782-2280
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Fax |
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Provider Business Mailing Address
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Address Line | 32390 PINTO DR
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City | SPRINGVILLE
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State | CA
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Zip | 93265-9313
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Country | US
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Telephone | 559-782-2280
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Fax | 559-539-2803
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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 | A43886
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | A43886
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License Number State | CA
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