Provider Demographics
NPI:1245790922
Name:TAUBMAN, DANIELLE SAMANTHA (MD)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:SAMANTHA
Last Name:TAUBMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1925 ARIZONA AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-1287
Mailing Address - Country:US
Mailing Address - Phone:424-216-6991
Mailing Address - Fax:628-246-8591
Practice Address - Street 1:1925 ARIZONA AVE STE 201
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-1287
Practice Address - Country:US
Practice Address - Phone:424-216-6991
Practice Address - Fax:628-246-8591
Is Sole Proprietor?:No
Enumeration Date:2019-03-20
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CA1767142084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program