Provider Demographics
NPI:1215358650
Name:KE, DANIEL (RPT)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:KE
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:417 W ALLEN AVE STE 116
Mailing Address - Street 2:
Mailing Address - City:SAN DIMAS
Mailing Address - State:CA
Mailing Address - Zip Code:91773-4723
Mailing Address - Country:US
Mailing Address - Phone:909-971-9334
Mailing Address - Fax:909-971-9654
Practice Address - Street 1:11190 WARNER AVE STE 300&302
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-4019
Practice Address - Country:US
Practice Address - Phone:714-893-6008
Practice Address - Fax:714-893-6168
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-03
Last Update Date:2014-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT71752251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic