Provider Demographics
NPI:1053632091
Name:GILBERT, DANIEL R (DO)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:R
Last Name:GILBERT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:DR
Other - First Name:DANIEL
Other - Middle Name:R
Other - Last Name:GILBERT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:1100 TRANCAS ST STE 201
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-2904
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1100 TRANCAS ST STE 201
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558-2904
Practice Address - Country:US
Practice Address - Phone:707-251-1867
Practice Address - Fax:707-257-4119
Is Sole Proprietor?:No
Enumeration Date:2010-06-14
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ006452208800000X
OH34010887208800000X, 390200000X
IL036.144100208800000X
CA20A15720208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program