Provider Demographics
NPI:1679756274
Name:DANIELA ENGLISH DO LLC
Entity Type:Organization
Organization Name:DANIELA ENGLISH DO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIELA
Authorized Official - Middle Name:P
Authorized Official - Last Name:ENGLISH
Authorized Official - Suffix:
Authorized Official - Credentials:DO LLC
Authorized Official - Phone:480-961-0760
Mailing Address - Street 1:4621 E CHANDLER BLVD
Mailing Address - Street 2:#110
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85048-0426
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4621 E CHANDLER BLVD
Practice Address - Street 2:#110
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85048-0426
Practice Address - Country:US
Practice Address - Phone:480-961-0760
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-06
Last Update Date:2007-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3478207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ82628Medicare PIN