Provider Demographics
NPI:1598093304
Name:THUILLIER, DANIEL UNGER (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:UNGER
Last Name:THUILLIER
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 1:1500 OWENS ST STE 200
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94158-2335
Mailing Address - Country:US
Mailing Address - Phone:415-353-9400
Mailing Address - Fax:
Practice Address - Street 1:1500 OWENS ST STE 200
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94158-2335
Practice Address - Country:US
Practice Address - Phone:415-353-9400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-07
Last Update Date:2020-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60332739207XX0004X
CAA108153207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CX216YOtherMEDICARE
CX216ZOtherMEDICARE
CX216XOtherMEDICARE