Provider Demographics
NPI:1013762434
Name:UMEMOTO, DANIEL (MD)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:
Last Name:UMEMOTO
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:ALAMEDA DEL CORREGIDOR 290, LA MOLINA
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:LIMA
Mailing Address - Zip Code:15024
Mailing Address - Country:PE
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:CALLE 2, 221, SURCO
Practice Address - Street 2:URBANIZACION LA HACIENDA
Practice Address - City:LIMA
Practice Address - State:LIMA
Practice Address - Zip Code:15023
Practice Address - Country:PE
Practice Address - Phone:519-911-3020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-19
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program