Provider Demographics
NPI:1851027528
Name:RINCON PEREZ, DANIEL ALEJANDRO (PA-C)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:ALEJANDRO
Last Name:RINCON PEREZ
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:DANIEL ALEJANDRO
Other - Middle Name:ALEJANDRA
Other - Last Name:RINCON PEREZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:PO BOX 1475
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50305-1475
Mailing Address - Country:US
Mailing Address - Phone:515-643-8100
Mailing Address - Fax:515-643-8139
Practice Address - Street 1:800 E 1ST ST STE 1700
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50021-2100
Practice Address - Country:US
Practice Address - Phone:515-643-8100
Practice Address - Fax:515-643-8139
Is Sole Proprietor?:No
Enumeration Date:2022-07-26
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA123992363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant