Provider Demographics
NPI:1285798736
Name:DANIELS, OWEN L (MD)
Entity type:Individual
Prefix:DR
First Name:OWEN
Middle Name:L
Last Name:DANIELS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4301 3RD ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94124-2101
Mailing Address - Country:US
Mailing Address - Phone:415-648-5785
Mailing Address - Fax:415-695-9830
Practice Address - Street 1:4301 3RD ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94124-2101
Practice Address - Country:US
Practice Address - Phone:415-648-5785
Practice Address - Fax:415-695-9830
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG472262084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA50628Medicare UPIN