Basic Information
| Provider Information | |||||||||
| NPI: | 1164613741 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DANIELSON | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | ALMY | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | HIGHWAY 1 | ||||||||
| Address2: | |||||||||
| City: | SAN LUIS OBISPO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 934090001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8055477911 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4255 S EL POMAR RD | ||||||||
| Address2: | |||||||||
| City: | TEMPLETON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 934658667 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8052370422 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/07/2007 | ||||||||
| LastUpdateDate: | 08/07/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | G35577 | CA | Y | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.