Provider Demographics
NPI:1629280565
Name:SALANDANAN, DANILO VIDOYA (MD)
Entity Type:Individual
Prefix:DR
First Name:DANILO
Middle Name:VIDOYA
Last Name:SALANDANAN
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 1:20586 CRESTLINE DR
Mailing Address - Street 2:
Mailing Address - City:DIAMOND BAR
Mailing Address - State:CA
Mailing Address - Zip Code:91765-4711
Mailing Address - Country:US
Mailing Address - Phone:909-598-2403
Mailing Address - Fax:
Practice Address - Street 1:2010 ZONAL AVE
Practice Address - Street 2:2P52 - UADC
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033
Practice Address - Country:US
Practice Address - Phone:323-226-3753
Practice Address - Fax:323-226-3261
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA051496207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0028228OtherMEDICAL UPIN
CA0028228OtherMEDICAL UPIN