MEDICARE: CODY DANIEL

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	225100000X	Physical Therapist	301918	CA

General Provider Information

NPI Number	:	1407589765
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CODY DANIEL

Provider Business Mailing Address
First Line	:	27621 MARTA LN APT 102
Second Line	:
City	:	SANTA CLARITA
State	:	CA
Zip	:	91387-6527
Country	:	US
Telephone Number	:	209-681-2782
Fax Number	:

Provider Business Practice Location Address
First Line	:	25949 THE OLD RD
Second Line	:
City	:	VALENCIA
State	:	CA
Zip	:	91381-1714
Country	:	US
Telephone Number	:	661-254-0077
Fax Number	:

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

Provider Enumeration Date	:	07/05/2022
Last Update Date	:	07/05/2022

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Directions to “ CODY DANIEL ” Practice Location

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