Provider Demographics
NPI:1356439038
Name:DALY, JOSEPH TERENCE (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:TERENCE
Last Name:DALY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:J
Other - Middle Name:TERENCE
Other - Last Name:DALY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:9834 GENESEE AVENUE
Mailing Address - Street 2:SUITE 315
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-1441
Mailing Address - Country:US
Mailing Address - Phone:858-457-4090
Mailing Address - Fax:858-457-1543
Practice Address - Street 1:9834 GENESEE AVENUE
Practice Address - Street 2:SUITE 315
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1221
Practice Address - Country:US
Practice Address - Phone:858-457-4090
Practice Address - Fax:858-457-1543
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG26296207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
180032742OtherRAILROAD MEDICARE
CA00G262960Medicaid
WG26296AMedicare ID - Type Unspecified
CA00G262960Medicaid