Provider Demographics
NPI:1508989831
Name:DEL PRADO, DANIEL (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:DEL PRADO
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 1:1770 IOWA AVE STE 280
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92507-7401
Mailing Address - Country:US
Mailing Address - Phone:951-786-0801
Mailing Address - Fax:787-777-3858
Practice Address - Street 1:CENTRO MEDICO DE PUERTO RICO, BO MONACILLOS
Practice Address - Street 2:RADIOLOGIA RCM
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00935
Practice Address - Country:US
Practice Address - Phone:787-777-3535
Practice Address - Fax:787-777-3858
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010892012085R0202X
PR170792085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5186406Medicaid
MI5186406Medicaid