Provider Demographics
NPI:1003390709
Name:METZGER, DANIEL (LAC)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:METZGER
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 1:460 MARIETTA DR
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94127-1820
Mailing Address - Country:US
Mailing Address - Phone:415-845-2323
Mailing Address - Fax:
Practice Address - Street 1:460 MARIETTA DR
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94127-1820
Practice Address - Country:US
Practice Address - Phone:415-845-2323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-18
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17787171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist