Provider Demographics
NPI:1780356972
Name:DALY, LINDSAY
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:
Last Name:DALY
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 1:16918 DOVE CANYON RD STE 102
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92127-3455
Mailing Address - Country:US
Mailing Address - Phone:858-292-5101
Mailing Address - Fax:858-408-2992
Practice Address - Street 1:16918 DOVE CANYON RD STE 102
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92127-3455
Practice Address - Country:US
Practice Address - Phone:858-292-5101
Practice Address - Fax:858-408-2992
Is Sole Proprietor?:No
Enumeration Date:2021-10-05
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA59911363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant