Provider Demographics
NPI:1336175991
Name:KANADA, DANIEL J (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:J
Last Name:KANADA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16075 GREENWOOD RD
Mailing Address - Street 2:
Mailing Address - City:MONTE SERENO
Mailing Address - State:CA
Mailing Address - Zip Code:95030-3016
Mailing Address - Country:US
Mailing Address - Phone:408-279-3225
Mailing Address - Fax:
Practice Address - Street 1:16075 GREENWOOD RD
Practice Address - Street 2:
Practice Address - City:MONTE SERENO
Practice Address - State:CA
Practice Address - Zip Code:95030-3016
Practice Address - Country:US
Practice Address - Phone:408-279-3225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-24
Last Update Date:2018-10-03
Deactivation Date:2011-01-07
Deactivation Code:
Reactivation Date:2018-10-03
Provider Licenses
StateLicense IDTaxonomies
CAG033555207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease