Provider Demographics
NPI:1205045028
Name:BINUS, DANIEL LUTZ (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:LUTZ
Last Name:BINUS
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:PO BOX 4418
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95604-4418
Mailing Address - Country:US
Mailing Address - Phone:530-889-8780
Mailing Address - Fax:
Practice Address - Street 1:13300 NEW AIRPORT RD
Practice Address - Street 2:SUITE 100
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95602-7407
Practice Address - Country:US
Practice Address - Phone:530-889-8780
Practice Address - Fax:530-889-8781
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2012-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1007102084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
EB584ZMedicare UPIN