Provider Demographics
NPI:1689170763
Name:MCDANIEL, ELIZABETH K (DACM, LAC)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:K
Last Name:MCDANIEL
Suffix:
Gender:F
Credentials:DACM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:736 DEL RIO AVE
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-2321
Mailing Address - Country:US
Mailing Address - Phone:562-243-7359
Mailing Address - Fax:
Practice Address - Street 1:736 DEL RIO AVE
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-2321
Practice Address - Country:US
Practice Address - Phone:562-243-7359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-05
Last Update Date:2018-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17844171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist