Provider Demographics
NPI:1205430477
Name:DANIEL L ROWADY MD PC
Entity type:Organization
Organization Name:DANIEL L ROWADY MD PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:ROWADY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-345-6880
Mailing Address - Street 1:10 CONGRESS ST STE 408
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-3023
Mailing Address - Country:US
Mailing Address - Phone:626-345-6880
Mailing Address - Fax:626-345-6882
Practice Address - Street 1:630 S RAYMOND AVE UNIT 240
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-3283
Practice Address - Country:US
Practice Address - Phone:626-345-6880
Practice Address - Fax:626-345-6882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-27
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA73692OtherSTATE LICENSE
CAA73692OtherSTATE LICENSE