Provider Demographics
NPI:1942332960
Name:PLOTKIN, DANIEL ALAN (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:ALAN
Last Name:PLOTKIN
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1823 SAWTELLE BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-5532
Mailing Address - Country:US
Mailing Address - Phone:310-477-7855
Mailing Address - Fax:310-477-0661
Practice Address - Street 1:1823 SAWTELLE BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-5532
Practice Address - Country:US
Practice Address - Phone:310-477-7855
Practice Address - Fax:310-477-0661
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2010-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG397122084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG39712AMedicare ID - Type Unspecified
CAA92112Medicare UPIN