Robert A. Daniels, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

E2039 Issued in CA

Practice address

1398 Los Osos Valley Rd
Suite D
Los Osos, CA 93402-3342

Phone

(805) 528-7643

Fax

(805) 528-0232

NPI assigned

Mar 3, 2006

Reactivated

Mar 13, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1141344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346803200000",
    "number": "1063489532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1398 LOS OSOS VALLEY RD",
            "address_2": "SUITE D",
            "city": "LOS OSOS",
            "state": "CA",
            "postal_code": "934023342",
            "telephone_number": "805-528-7643",
            "fax_number": "805-528-0232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1398 LOS OSOS VALLEY RD",
            "address_2": "SUITE D",
            "city": "LOS OSOS",
            "state": "CA",
            "postal_code": "934023342",
            "telephone_number": "805-528-7643",
            "fax_number": "805-528-0232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIELS",
        "first_name": "ROBERT",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-03",
        "last_updated": "2012-09-05",
        "deactivation_date": "2006-03-07",
        "reactivation_date": "2006-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E2039",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000E20390",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00E20391",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Los Osos, CA
• Podiatrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.