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General NPI Number Information
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NPI Number | 1922134907
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Entity Type | Individual
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Provider Name | DANIELA DRAKE M.D.
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Gender | Female
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 09/01/2010
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Provider Practice Location Address
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Address Line | 2750 E SLAUSON AVE
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City | HUNTINGTON PARK
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State | CA
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Zip | 90255-3063
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Country | US
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Telephone | 323-583-3010
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Fax |
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Provider Business Mailing Address
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Address Line | 7305 HANNUM AVE
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City | CULVER CITY
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State | CA
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Zip | 90230-6150
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Country | US
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Telephone | 310-397-1812
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | G75951
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License Number State | CA
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