Provider Demographics
NPI:1457825812
Name:LINK, DANIEL JAMES (PHARMD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:JAMES
Last Name:LINK
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 N LAKE BLVD
Mailing Address - Street 2:
Mailing Address - City:TAHOE CITY
Mailing Address - State:CA
Mailing Address - Zip Code:96145-9800
Mailing Address - Country:US
Mailing Address - Phone:530-584-0250
Mailing Address - Fax:530-584-0255
Practice Address - Street 1:950 N LAKE BLVD
Practice Address - Street 2:
Practice Address - City:TAHOE CITY
Practice Address - State:CA
Practice Address - Zip Code:96145-9800
Practice Address - Country:US
Practice Address - Phone:530-584-0250
Practice Address - Fax:530-584-0255
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-17
Last Update Date:2019-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA71474183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist