Provider Demographics
NPI:1497847032
Name:MUNZER, DARYL D (MD)
Entity Type:Individual
Prefix:
First Name:DARYL
Middle Name:D
Last Name:MUNZER
Suffix:
Gender:M
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:PO BOX 255228
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95865-5228
Mailing Address - Country:US
Mailing Address - Phone:800-470-0071
Mailing Address - Fax:
Practice Address - Street 1:400 PLUMAS BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991
Practice Address - Country:US
Practice Address - Phone:530-749-5560
Practice Address - Fax:530-749-5565
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG55385207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP00770122OtherRAILROAD MEDICARE
CA00G553850Medicaid
CA00G553850Medicaid
A52936Medicare UPIN
CAAM3215034OtherDEA