Provider Demographics
NPI:1306332051
Name:IGNACIO, DANIEL ANDRE (MS)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:ANDRE
Last Name:IGNACIO
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1156 WRIGHT LN
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92833-5774
Mailing Address - Country:US
Mailing Address - Phone:657-217-2297
Mailing Address - Fax:
Practice Address - Street 1:1001 S GRAND AVE
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-4121
Practice Address - Country:US
Practice Address - Phone:714-836-2736
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-05
Last Update Date:2018-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program