Provider Demographics
NPI:1659959567
Name:MALLEY, DANIEL JAMES (DO)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:JAMES
Last Name:MALLEY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4363 S QUEBEC ST APT 5201
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-2653
Mailing Address - Country:US
Mailing Address - Phone:702-412-7885
Mailing Address - Fax:
Practice Address - Street 1:10101 RIDGEGATE PKWY
Practice Address - Street 2:
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-5522
Practice Address - Country:US
Practice Address - Phone:720-225-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-31
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CO1659959567207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program