Provider Demographics
NPI:1639523491
Name:HYNES, DANIEL ANTHONY (MB BCH BAO)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:ANTHONY
Last Name:HYNES
Suffix:
Gender:M
Credentials:MB BCH BAO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 PASTEUR DR RM H1307
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94304-2206
Mailing Address - Country:US
Mailing Address - Phone:650-723-8463
Mailing Address - Fax:
Practice Address - Street 1:300 PASTEUR DR RM H1307
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304-2206
Practice Address - Country:US
Practice Address - Phone:650-723-8463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-19
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1719132085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty