Provider Demographics
NPI:1184910044
Name:OBERLIN, DANIEL THOMAS (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:THOMAS
Last Name:OBERLIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2999 REGENT ST STE 612
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94705-2121
Mailing Address - Country:US
Mailing Address - Phone:510-848-1727
Mailing Address - Fax:510-848-8224
Practice Address - Street 1:2999 REGENT ST STE 612
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705-2121
Practice Address - Country:US
Practice Address - Phone:510-848-1727
Practice Address - Fax:510-848-8224
Is Sole Proprietor?:No
Enumeration Date:2011-06-20
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL125060125208800000X
CAA149464208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology