Provider Demographics
NPI:1154375541
Name:HONIGMAN, DANIEL (MD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:HONIGMAN
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 1:3180 COLIMA RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:HACIENDA HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91745-6315
Mailing Address - Country:US
Mailing Address - Phone:626-961-1644
Mailing Address - Fax:626-333-1079
Practice Address - Street 1:3120 S HACIENDA BLVD STE 101
Practice Address - Street 2:
Practice Address - City:HACIENDA HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:91745-6305
Practice Address - Country:US
Practice Address - Phone:833-402-5804
Practice Address - Fax:626-478-2145
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-20
Last Update Date:2018-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG38407207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
025236OtherHEALTH NET ID #
CA00G384070Medicaid
080138287OtherRAILROAD
00G384070OtherBLUE SHIELD ID #
CAWG38407DMedicare PIN
025236OtherHEALTH NET ID #
080138287OtherRAILROAD
CAWG38407BMedicare PIN