Provider Demographics
NPI:1306691464
Name:DANIEL L. MONAHAN M.D.
Entity type:Organization
Organization Name:DANIEL L. MONAHAN M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MERIDITH
Authorized Official - Middle Name:D
Authorized Official - Last Name:MINEAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-791-8346
Mailing Address - Street 1:1211 PLEASANT GROVE BLVD STE 120
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95678-6988
Mailing Address - Country:US
Mailing Address - Phone:916-791-8346
Mailing Address - Fax:916-791-8833
Practice Address - Street 1:1211 PLEASANT GROVE BLVD STE 120
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95678-6988
Practice Address - Country:US
Practice Address - Phone:916-791-8346
Practice Address - Fax:916-791-8833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-22
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty