MEDICARE: DANIELA ENGLISH DO LLC

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	207Q00000X	Family Medicine Physician	3478	AZ

General Provider Information

NPI Number	:	1679756274
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DANIELA ENGLISH DO LLC

Provider Business Mailing Address
First Line	:	4621 E CHANDLER BLVD
Second Line	:	#110
City	:	PHOENIX
State	:	AZ
Zip	:	85048-0426
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4621 E CHANDLER BLVD
Second Line	:	#110
City	:	PHOENIX
State	:	AZ
Zip	:	85048-0426
Country	:	US
Telephone Number	:	480-961-0760
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DANIELA P ENGLISH
Credential	:	DO LLC
Telephone Number	:	480-961-0760

Provider Enumeration Date	:	12/06/2007
Last Update Date	:	12/06/2007

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