Daniell Bennett Pollack, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA2005 Issued in CA

Practice address

4065 3Rd Avenue
Suite 102
San Diego, CA 92103-2184

Phone

(619) 542-0013

Fax

(619) 542-0559

NPI assigned

Nov 12, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Daniell Margaret Bennett Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1226448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275868800000",
    "number": "1376797795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4065 3RD AVENUE",
            "address_2": "SUITE 102",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032184",
            "telephone_number": "619-542-0013",
            "fax_number": "619-542-0559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4065 3RD AVENUE",
            "address_2": "SUITE 102",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032184",
            "telephone_number": "619-542-0013",
            "fax_number": "619-542-0559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLLACK",
        "first_name": "DANIELL",
        "middle_name": "BENNETT",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-12",
        "last_updated": "2010-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA20005",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA2005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANIELL",
            "last_name": "BENNETT",
            "middle_name": "MARGARET",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sarah A Polk
• Thomas Polk
• Harry Polkinhorn, PH.D.
• Mary C. Polkoski, PA-C
• Andrew Pollack, LAC
• Jobeth Pollack, RN
• Larry Howard Pollack, M.D.
• Robert B Pollack, M.D.
• Rory Pollack
• Sandra Hop Pollack

• Medical Physician Assistant in San Diego, CA
• Providers in San Diego, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2010; 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.