Provider Demographics
NPI:1457504029
Name:DANESHVAR, DANIEL ARAM (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:ARAM
Last Name:DANESHVAR
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 1:1510 S CENTRAL AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91204-2541
Mailing Address - Country:US
Mailing Address - Phone:818-247-0160
Mailing Address - Fax:
Practice Address - Street 1:1510 S CENTRAL AVE STE 150
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91204-2541
Practice Address - Country:US
Practice Address - Phone:818-247-0160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-28
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA111947207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease