Provider Demographics
NPI:1851170633
Name:ALTAMIRANO ABAD, DANIEL (MD)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:
Last Name:ALTAMIRANO ABAD
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 1:1050 S NORTON AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90019-3209
Mailing Address - Country:US
Mailing Address - Phone:323-679-3442
Mailing Address - Fax:
Practice Address - Street 1:2720 S BRISTOL ST
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92704-6207
Practice Address - Country:US
Practice Address - Phone:714-426-5222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-21
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAP29207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine