Provider Demographics
NPI:1033214796
Name:WHITE, DANIEL V (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:V
Last Name:WHITE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:340 4TH AVE
Mailing Address - Street 2:#5A
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91910-3813
Mailing Address - Country:US
Mailing Address - Phone:619-476-7958
Mailing Address - Fax:619-476-7963
Practice Address - Street 1:340 4TH AVE
Practice Address - Street 2:#5A
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-3813
Practice Address - Country:US
Practice Address - Phone:619-476-7958
Practice Address - Fax:619-476-7963
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2014-05-20
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Provider Licenses
StateLicense IDTaxonomies
CAA87387207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A873870Medicaid
CA00A873870Medicaid
CAI14885Medicare UPIN