Provider Demographics
NPI:1114373370
Name:IRBY, DANIEL PEIXOTO (MD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:PEIXOTO
Last Name:IRBY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:440 N BARRANCA AVE
Mailing Address - Street 2:PMB 1143
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91723-1722
Mailing Address - Country:US
Mailing Address - Phone:510-497-1882
Mailing Address - Fax:572-900-2198
Practice Address - Street 1:17 GLEN EDEN AVE UNIT 6
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-4316
Practice Address - Country:US
Practice Address - Phone:510-497-1882
Practice Address - Fax:572-900-2198
Is Sole Proprietor?:No
Enumeration Date:2016-05-06
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA1524882084P0800X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice