MEDICARE: ROBERT ALMY DANIELSON M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	G35577	CA

General Provider Information

NPI Number	:	1164613741
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT ALMY DANIELSON M.D.

Provider Business Mailing Address
First Line	:	HIGHWAY 1
Second Line	:
City	:	SAN LUIS OBISPO
State	:	CA
Zip	:	93409-0001
Country	:	US
Telephone Number	:	805-547-7911
Fax Number	:

Provider Business Practice Location Address
First Line	:	4255 S EL POMAR RD
Second Line	:
City	:	TEMPLETON
State	:	CA
Zip	:	93465-8667
Country	:	US
Telephone Number	:	805-237-0422
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/07/2007
Last Update Date	:	08/07/2007

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