Basic Information
Provider Information
NPI: 1548589799
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FRANC
FirstName: DANIEL
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2811 WILSHIRE BLVD STE 800
Address2:  
City: SANTA MONICA
State: CA
PostalCode: 904034808
CountryCode: US
TelephoneNumber: 3108295968
FaxNumber:  
Practice Location
Address1: 2811 WILSHIRE BLVD STE 800
Address2:  
City: SANTA MONICA
State: CA
PostalCode: 904034808
CountryCode: US
TelephoneNumber: 6128733000
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/27/2010
LastUpdateDate: 02/27/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/27/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084N0400XA119764CAY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology

No ID Information.


Home