MEDICARE: DR. DANIEL E HARDY 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	207Q00000X	Family Medicine Physician	G77650	CA

General Provider Information

NPI Number	:	1689679045
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL E HARDY M.D.

Provider Business Mailing Address
First Line	:	801 W L ST
Second Line	:
City	:	LOS BANOS
State	:	CA
Zip	:	93635-3953
Country	:	US
Telephone Number	:	209-826-5787
Fax Number	:

Provider Business Practice Location Address
First Line	:	801 W L ST
Second Line	:
City	:	LOS BANOS
State	:	CA
Zip	:	93635-3953
Country	:	US
Telephone Number	:	209-827-3303
Fax Number	:	209-827-3743

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

Provider Enumeration Date	:	06/14/2005
Last Update Date	:	06/18/2024

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