Provider Demographics
NPI:1801196803
Name:MARKS, DANIEL JOHN (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:JOHN
Last Name:MARKS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 COAST VILLAGE RD
Mailing Address - Street 2:
Mailing Address - City:MONTECITO
Mailing Address - State:CA
Mailing Address - Zip Code:93108-2715
Mailing Address - Country:US
Mailing Address - Phone:805-969-4728
Mailing Address - Fax:805-969-2069
Practice Address - Street 1:1020 COAST VILLAGE RD
Practice Address - Street 2:
Practice Address - City:MONTECITO
Practice Address - State:CA
Practice Address - Zip Code:93108-2715
Practice Address - Country:US
Practice Address - Phone:805-969-4728
Practice Address - Fax:805-969-2069
Is Sole Proprietor?:No
Enumeration Date:2010-10-25
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 60075183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist