Provider Demographics
NPI:1780030742
Name:TALAMO, DANIEL (DO)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:
Last Name:TALAMO
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 1:13026 W RANCHO SANTA FE BLVD STE C-100
Mailing Address - Street 2:
Mailing Address - City:AVONDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85392-1712
Mailing Address - Country:US
Mailing Address - Phone:602-491-0703
Mailing Address - Fax:623-491-0703
Practice Address - Street 1:13026 W RANCHO SANTA FE BLVD STE C-100
Practice Address - Street 2:
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85392-1712
Practice Address - Country:US
Practice Address - Phone:602-491-0703
Practice Address - Fax:833-491-2143
Is Sole Proprietor?:No
Enumeration Date:2016-05-09
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ008081207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine