Provider Demographics
NPI:1144863481
Name:VALDEZ, DANIEL E (PA-C)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:E
Last Name:VALDEZ
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10097
Mailing Address - Street 2:
Mailing Address - City:CASA GRANDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85130-0020
Mailing Address - Country:US
Mailing Address - Phone:208-363-4465
Mailing Address - Fax:
Practice Address - Street 1:1040 W AMERICAN AVE
Practice Address - Street 2:
Practice Address - City:ORACLE
Practice Address - State:AZ
Practice Address - Zip Code:85623-6089
Practice Address - Country:US
Practice Address - Phone:520-896-2092
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-18
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant