Provider Demographics
NPI:1396147682
Name:DANIEL MEDICAL GROUP, INC.
Entity type:Organization
Organization Name:DANIEL MEDICAL GROUP, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SE YEONG
Authorized Official - Middle Name:
Authorized Official - Last Name:OH
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:949-892-9929
Mailing Address - Street 1:2012 BROOKE LANE.
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92833
Mailing Address - Country:US
Mailing Address - Phone:714-340-6590
Mailing Address - Fax:714-236-9097
Practice Address - Street 1:2015 W REDONDO BEACH BLVD.
Practice Address - Street 2:STE F
Practice Address - City:GARDENA
Practice Address - State:CA
Practice Address - Zip Code:90247
Practice Address - Country:US
Practice Address - Phone:424-340-9357
Practice Address - Fax:424-340-9357
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-18
Last Update Date:2017-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC10176171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty