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NPI Code Detail

MEDICARE: DR. CLAYTON RICHARD MCDANIEL MD

MEDICARE:  DR. CLAYTON RICHARD MCDANIEL  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 PhysicianA87092CA

General Provider Information

NPI Number : 1851326458
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CLAYTON RICHARD MCDANIEL MD
Provider Business Mailing Address
First Line : 3400 DATA DR
Second Line : ATTN: CREDENTIALING/PAYER ENROLLMENT
City : RANCHO CORDOVA
State : CA
Zip : 95670-7956
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 575 AUTO CENTER DR
Second Line :
City : WATSONVILLE
State : CA
Zip : 95076-3727
Country : US
Telephone Number : 831-288-6537
Fax Number : 831-722-2855
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2006
Last Update Date : 04/24/2023

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