Provider Demographics
NPI:1295977932
Name:JANDIAL, DANIELLE D
Entity type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:D
Last Name:JANDIAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:460 TANGERINE PL
Mailing Address - Street 2:
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92823-1809
Mailing Address - Country:US
Mailing Address - Phone:714-854-0016
Mailing Address - Fax:
Practice Address - Street 1:101 THE CITY DR.
Practice Address - Street 2:BLDG. 56, ROOM 260
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92683-1491
Practice Address - Country:US
Practice Address - Phone:714-456-8028
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-26
Last Update Date:2009-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA83406207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology