Provider Demographics
NPI:1740440791
Name:FITZPATRICK, DANIEL M
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:M
Last Name:FITZPATRICK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13828 VANOWEN ST
Mailing Address - Street 2:#2
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91405-5504
Mailing Address - Country:US
Mailing Address - Phone:818-943-1482
Mailing Address - Fax:818-374-5388
Practice Address - Street 1:14411 VANOWEN ST
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-4038
Practice Address - Country:US
Practice Address - Phone:818-374-5383
Practice Address - Fax:818-374-5388
Is Sole Proprietor?:No
Enumeration Date:2008-06-12
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner