Provider Demographics
NPI:1154464048
Name:ALLEN, DANIEL MERRILL (DO)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:MERRILL
Last Name:ALLEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:433 COYOTE ST
Mailing Address - Street 2:
Mailing Address - City:NEVADA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95959-2230
Mailing Address - Country:US
Mailing Address - Phone:530-478-5770
Mailing Address - Fax:530-478-5771
Practice Address - Street 1:433 COYOTE ST
Practice Address - Street 2:
Practice Address - City:NEVADA CITY
Practice Address - State:CA
Practice Address - Zip Code:95959-2230
Practice Address - Country:US
Practice Address - Phone:530-478-5770
Practice Address - Fax:530-478-5771
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2016-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A-6486204D00000X, 204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM