Provider Demographics
NPI:1184665721
Name:DELGADO, DANIEL CARLOS (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:CARLOS
Last Name:DELGADO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8161 N MARION AVE
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93619-9142
Mailing Address - Country:US
Mailing Address - Phone:559-332-9345
Mailing Address - Fax:
Practice Address - Street 1:1303 E HERNDON AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-3309
Practice Address - Country:US
Practice Address - Phone:559-450-3205
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG51483207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
00G514830OtherBS OF CA
CA00G514830Medicaid
G51483OtherBC OF CA
CR0087Medicare PIN
G51483OtherBC OF CA
CA00G514830Medicaid
00G514830Medicare PIN
930005665Medicare PIN