Daniel R Lamothe, M.D.
Individual provider Active NPI Ophthalmology Physician · Edwards Afb, CA
NPI 1023071107 · NPPES record last updated May 20, 2021
Key facts
- NPI
- 1023071107
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Ophthalmology Physician 207W00000X
- License
- 01058224A (IN)
- Practice address
- 30 Nightingale Road
Edwards Afb, CA 93524-0001 - Phone
- (661) 277-2397
- NPI assigned
- Apr 10, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01058224A | IN | MD | Ophthalmology Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 01058224A | IN | Yes |
Addresses
Primary practice location
30 Nightingale Road
Edwards Afb, CA 93524-0001
Mailing address
30 Nightingale Road
Edwards Afb, CA 93524-0001
Phone (661) 277-2397
Other practice location 1
4700 Las Vegas Blvd N
Nellis AFB, NV 89191-6600
Phone (702) 653-3020
Other providers in Edwards Afb, CA
- Michael Hasler
- Arlene Johnson
- Ain Kang
- Jun Kyung Ko
- Melanie Lamb
- Jesse Lee
- Patricia Ann Macsparran
- James Michael Medeiros
- Dawn Michaela Morales
- Kayla Cristina Mowatt Diamreyan
All providers in Edwards Afb, CA · Ophthalmology Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 20, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.