Provider Demographics
NPI:1255419800
Name:DANILYCHEV, MARIA V (MD)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:V
Last Name:DANILYCHEV
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4420 HOTEL CIRCLE CT STE 265
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-3434
Mailing Address - Country:US
Mailing Address - Phone:844-977-2255
Mailing Address - Fax:
Practice Address - Street 1:24065 BIGGAR LN
Practice Address - Street 2:
Practice Address - City:COVELO
Practice Address - State:CA
Practice Address - Zip Code:95428-0247
Practice Address - Country:US
Practice Address - Phone:707-983-6181
Practice Address - Fax:707-983-6802
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA82520207R00000X, 207RH0002X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABT416ZMedicare PIN