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General NPI Number Information
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NPI Number | 1891517157
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Entity Type | Individual
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Provider Name | ISABELLA DANIELS PA-C
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Gender | Female
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Dates
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Enumeration Date | 10/28/2024
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 3750 CONVOY ST STE 301
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City | SAN DIEGO
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State | CA
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Zip | 92111-3741
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Country | US
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Telephone | 619-297-4481
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Fax |
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Provider Business Mailing Address
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Address Line | 1342 FRANKFORT ST APT 6302
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City | SAN DIEGO
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State | CA
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Zip | 92110-3786
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Country | US
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Telephone | 408-930-8806
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 65260
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License Number State | CA
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