Provider Demographics
NPI:1225376817
Name:PREMIER PHYSICIAN SERVICES
Entity Type:Organization
Organization Name:PREMIER PHYSICIAN SERVICES
Other - Org Name:DR. MARIA DANILYCHEV, M.D., INC.
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DANILYCHEV
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:858-775-3587
Mailing Address - Street 1:4445 EASTGATE MALL
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-1979
Mailing Address - Country:US
Mailing Address - Phone:855-652-4946
Mailing Address - Fax:
Practice Address - Street 1:4445 EASTGATE MALL
Practice Address - Street 2:SUITE 200
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-1979
Practice Address - Country:US
Practice Address - Phone:855-652-4946
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-16
Last Update Date:2015-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Single Specialty