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General NPI Number Information
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NPI Number | 1790937068
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Entity Type | Individual
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Provider Name | DANIEL MARANCENBAUM MD
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Gender | Male
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Dates
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Enumeration Date | 10/18/2008
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Last Update Date | 10/06/2022
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Provider Practice Location Address
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Address Line | 3917 WEST RD STE 250
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City | LOS ALAMOS
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State | NM
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Zip | 87544-5302
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Country | US
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Telephone | 505-661-9201
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Fax | 505-661-9185
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Provider Business Mailing Address
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Address Line | 2055 WALSBROOK
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City | SAN ANTONIO
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State | TX
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Zip | 78260-2436
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Country | US
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Telephone | 505-695-0541
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | ME152170
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 042.0012038
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License Number State | VT
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Taxonomy #3
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | MT189844
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | MD2013-0460
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License Number State | NM
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