Provider Demographics
NPI:1215978176
Name:DANON, GUY DANIEL (DPM)
Entity type:Individual
Prefix:DR
First Name:GUY
Middle Name:DANIEL
Last Name:DANON
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4217 LUTHER ST
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-2853
Mailing Address - Country:US
Mailing Address - Phone:951-788-2001
Mailing Address - Fax:
Practice Address - Street 1:751 WESTHOLME AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90024-3315
Practice Address - Country:US
Practice Address - Phone:562-208-9407
Practice Address - Fax:310-341-3142
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE3542213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00035420Medicaid
CA00035420Medicaid
CAE3542AMedicare ID - Type Unspecified