Daniel E Gormley, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

A21148 Issued in CA

Practice address

412 W Carroll Ave
Ste 207
Glendora, CA 91741-4240

Phone

(626) 963-7684

Fax

(626) 963-0575

NPI assigned

Dec 14, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203379200000",
    "number": "1386629210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 W CARROLL AVE",
            "address_2": "STE 207",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917414240",
            "telephone_number": "626-963-7684",
            "fax_number": "626-963-0575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 W CARROLL AVE",
            "address_2": "STE 207",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917414240",
            "telephone_number": "626-963-7684",
            "fax_number": "626-963-0575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORMLEY",
        "first_name": "DANIEL",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-14",
        "last_updated": "2008-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A21148",
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "CA",
            "license": "A21148",
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "CA",
            "license": "A21148",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "CA",
            "license": "A21148",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thania Lizzeth Gonzalez Barceleau
• Desandra Gonzalez, MSW
• Esteban Gonzalez, REGISTERED NURSE
• Ruby Gonzalez, M.D.
• Donna Lynn Gordon, LCSW 29681
• Judith Goss
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• Graceful Hospice Care Inc
• Wanda Lou Griffin, RN
• Judy Elizabeth Grover, LMFT

• Dermatology Physician in Glendora, CA
• Providers in Glendora, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2008; 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.