Provider Demographics
NPI:1386208148
Name:TOBIN, DANIEL CHARLES
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:CHARLES
Last Name:TOBIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:675 TRANCAS ST
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-3084
Mailing Address - Country:US
Mailing Address - Phone:707-252-2844
Mailing Address - Fax:707-252-4864
Practice Address - Street 1:675 TRANCAS ST
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558-3084
Practice Address - Country:US
Practice Address - Phone:707-252-2844
Practice Address - Fax:707-252-4864
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-26
Last Update Date:2019-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28070183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA28070OtherPHARMACIST