MEDICARE: DANIEL HOWARD ALCALA 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
1	207R00000X	Internal Medicine Physician	G38323	CA

General Provider Information

NPI Number	:	1780780718
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL HOWARD ALCALA MD

Provider Business Mailing Address
First Line	:	10775 FRENCH CREEK RD
Second Line	:
City	:	PALO CEDRO
State	:	CA
Zip	:	96073-9527
Country	:	US
Telephone Number	:	530-243-1134
Fax Number	:	530-549-3802

Provider Business Practice Location Address
First Line	:	10775 FRENCH CREEK RD
Second Line	:
City	:	PALO CEDRO
State	:	CA
Zip	:	96073-9527
Country	:	US
Telephone Number	:	530-243-1134
Fax Number	:	530-549-3802

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

Provider Enumeration Date	:	09/16/2006
Last Update Date	:	08/25/2016

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