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NPI Code Detail

MEDICARE: DR. DANIEL KIDANE GOBA M.D.

MEDICARE: DR. DANIEL KIDANE GOBA 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
1207RP1001XPulmonary Disease PhysicianA112723CA
2207RC0200XCritical Care Medicine (Internal Medicine) PhysicianA112723CA
3282N00000XGeneral Acute Care HospitalA112723CA
4390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1306031810
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DANIEL KIDANE GOBA M.D.
Provider Business Mailing Address
First Line : 1910 OUTLET CENTER DR
Second Line :
City : OXNARD
State : CA
Zip : 93036-0677
Country : US
Telephone Number : 805-485-2400
Fax Number :
Provider Business Practice Location Address
First Line : 1910 OUTLET CENTER DR
Second Line :
City : OXNARD
State : CA
Zip : 93036-0677
Country : US
Telephone Number : 805-485-2400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/07/2007
Last Update Date : 07/22/2013

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