Provider Demographics
NPI:1578661609
Name:ROWADY, DANIEL LYNDON (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:LYNDON
Last Name:ROWADY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:591 S MARENGO AVE UNIT 5
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91106-3633
Mailing Address - Country:US
Mailing Address - Phone:626-432-7477
Mailing Address - Fax:
Practice Address - Street 1:630 S RAYMOND AVE
Practice Address - Street 2:SUITE 320
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-3278
Practice Address - Country:US
Practice Address - Phone:626-535-4724
Practice Address - Fax:626-795-2473
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA73692207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00460730OtherRAILROAD MEDICARE
WA73692CMedicare PIN
P00460730OtherRAILROAD MEDICARE