Provider Demographics
NPI:1306840137
Name:STOBBE, DANIEL ERWIN (MD, FACNP)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:ERWIN
Last Name:STOBBE
Suffix:
Gender:M
Credentials:MD, FACNP
Other - Prefix:
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Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6121 N THESTA ST
Mailing Address - Street 2:STE 207
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-5294
Mailing Address - Country:US
Mailing Address - Phone:559-449-2640
Mailing Address - Fax:559-432-7020
Practice Address - Street 1:6121 N THESTA ST
Practice Address - Street 2:STE 207
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-5294
Practice Address - Country:US
Practice Address - Phone:559-449-2640
Practice Address - Fax:559-432-7020
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-09
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG72604207UN0902X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207UN0902XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Imaging & Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG72604OtherMEDICAL LICENSE
CAG72604OtherMEDICAL LICENSE
F96150Medicare UPIN