Provider Demographics
NPI:1063620573
Name:OVADIA, DANIEL N (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:N
Last Name:OVADIA
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 1:2040 ALAMEDA PADRE SERRA
Mailing Address - Street 2:SUITE 109
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93103
Mailing Address - Country:US
Mailing Address - Phone:805-965-2336
Mailing Address - Fax:805-965-2666
Practice Address - Street 1:2040 ALAMEDA PADRE SERRA STE 109
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93103-1760
Practice Address - Country:US
Practice Address - Phone:805-965-2336
Practice Address - Fax:805-965-2666
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG54940174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA52834Medicare UPIN