Provider Demographics
NPI:1689616138
Name:DUNLEVY, DANIEL B (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:B
Last Name:DUNLEVY
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 1:5510 BIRDCAGE ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CITRUS HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:95610-7620
Mailing Address - Country:US
Mailing Address - Phone:916-967-9300
Mailing Address - Fax:916-967-9301
Practice Address - Street 1:5510 BIRDCAGE ST
Practice Address - Street 2:SUITE 100
Practice Address - City:CITRUS HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:95610-7620
Practice Address - Country:US
Practice Address - Phone:916-967-9300
Practice Address - Fax:916-967-9301
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-11
Last Update Date:2009-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG61359208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation