Provider Demographics
NPI:1023700986
Name:TAAMILO, DAISY SATALA
Entity type:Individual
Prefix:
First Name:DAISY
Middle Name:SATALA
Last Name:TAAMILO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9649 LAKEWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90240-3308
Mailing Address - Country:US
Mailing Address - Phone:562-417-7449
Mailing Address - Fax:562-280-2814
Practice Address - Street 1:9649 LAKEWOOD BLVD
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90240-3308
Practice Address - Country:US
Practice Address - Phone:562-417-7449
Practice Address - Fax:562-280-2814
Is Sole Proprietor?:No
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist