Provider Demographics
NPI:1447558671
Name:HAGE, DANIEL ANTONIOS
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:ANTONIOS
Last Name:HAGE
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 1:14576 STETSON RD
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95033-9706
Mailing Address - Country:US
Mailing Address - Phone:408-712-3392
Mailing Address - Fax:
Practice Address - Street 1:14576 STETSON RD
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95033-9706
Practice Address - Country:US
Practice Address - Phone:408-712-3392
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-11
Last Update Date:2011-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator