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NPI Code Detail

MEDICARE: MR. DANIEL ABDIAS VALLECILLO B.A.

MEDICARE:  MR. DANIEL ABDIAS VALLECILLO  B.A.
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
1225400000XRehabilitation Practitioner

General Provider Information

NPI Number : 1659400117
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DANIEL ABDIAS VALLECILLO B.A.
Provider Business Mailing Address
First Line : 2933 EL NIDO DR
Second Line :
City : ALTADENA
State : CA
Zip : 91001-4529
Country : US
Telephone Number : 626-395-7100
Fax Number :
Provider Business Practice Location Address
First Line : 2933 EL NIDO DR
Second Line :
City : ALTADENA
State : CA
Zip : 91001-4529
Country : US
Telephone Number : 626-395-7100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/02/2007
Last Update Date : 08/29/2013

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Directions to “ MR. DANIEL ABDIAS VALLECILLO B.A.” Practice Location

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