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NPI Code Detail

MEDICARE: DANIELA DRAKE M.D.

MEDICARE: DANIELA DRAKE 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
1207R00000XInternal Medicine PhysicianG75951CA

General Provider Information

NPI Number : 1922134907
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIELA DRAKE M.D.
Provider Business Mailing Address
First Line : 7305 HANNUM AVE
Second Line :
City : CULVER CITY
State : CA
Zip : 90230-6150
Country : US
Telephone Number : 310-397-1812
Fax Number :
Provider Business Practice Location Address
First Line : 2750 E SLAUSON AVE
Second Line :
City : HUNTINGTON PARK
State : CA
Zip : 90255-3063
Country : US
Telephone Number : 323-583-3010
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/26/2007
Last Update Date : 09/01/2010

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