Provider Demographics
NPI:1033173968
Name:MANUEL-ARGUELLES, DAISY (DO)
Entity Type:Individual
Prefix:
First Name:DAISY
Middle Name:
Last Name:MANUEL-ARGUELLES
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:270 PERKINS STREET
Mailing Address - Street 2:
Mailing Address - City:SONOMA
Mailing Address - State:CA
Mailing Address - Zip Code:95476-6955
Mailing Address - Country:US
Mailing Address - Phone:707-938-3131
Mailing Address - Fax:707-938-3678
Practice Address - Street 1:270 PERKINS STREET
Practice Address - Street 2:
Practice Address - City:SONOMA
Practice Address - State:CA
Practice Address - Zip Code:95476-6955
Practice Address - Country:US
Practice Address - Phone:707-938-3131
Practice Address - Fax:707-938-3678
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2015-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A7339207Q00000X
NY210304207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAYYY48627YMedicaid
CA020A73390OtherPIN
CAYYY48627YMedicaid
CAYYY48627YMedicare PIN