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NPI Code Detail

MEDICARE: DANIEL GHIYAM MD

MEDICARE: DANIEL GHIYAM MD
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
1207Q00000XFamily Medicine PhysicianA75370CA

General Provider Information

NPI Number : 1750378188
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIEL GHIYAM MD
Provider Business Mailing Address
First Line : 2840 E LOS ANGELES AVE
Second Line :
City : SIMI VALLEY
State : CA
Zip : 93065-3937
Country : US
Telephone Number : 805-526-8360
Fax Number : 805-526-1438
Provider Business Practice Location Address
First Line : 2840 E LOS ANGELES AVE
Second Line :
City : SIMI VALLEY
State : CA
Zip : 93065-3937
Country : US
Telephone Number : 805-526-8360
Fax Number : 805-526-1438
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/30/2005
Last Update Date : 03/01/2010

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Directions to “ DANIEL GHIYAM MD” Practice Location

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