Provider Demographics
NPI:1023273356
Name:DANICARE FAMILY HEALTH, INC.
Entity type:Organization
Organization Name:DANICARE FAMILY HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:K
Authorized Official - Last Name:IEM
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:267-973-2283
Mailing Address - Street 1:935 E PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-3425
Mailing Address - Country:US
Mailing Address - Phone:760-747-7512
Mailing Address - Fax:760-747-1253
Practice Address - Street 1:701 E GRAND AVE STE 100
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-4466
Practice Address - Country:US
Practice Address - Phone:760-294-8898
Practice Address - Fax:760-294-8827
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-25
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A9702208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty