Provider Demographics
NPI:1003088501
Name:KNIGHT, DANIEL S (LAC)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:S
Last Name:KNIGHT
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:719 W PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-3803
Mailing Address - Country:US
Mailing Address - Phone:619-972-1757
Mailing Address - Fax:
Practice Address - Street 1:4002 PARK BLVD
Practice Address - Street 2:SUITE E
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-2600
Practice Address - Country:US
Practice Address - Phone:619-972-1757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-25
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12349171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist