Provider Demographics
NPI:1942464771
Name:HOUSEMAN, DANIEL EDWARD (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:EDWARD
Last Name:HOUSEMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:1050 LINDEN AVE
Mailing Address - Street 2:LONG BEACH EMERGENCY MEDICAL GROUP
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90813-3321
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1050 LINDEN AVE
Practice Address - Street 2:LONG BEACH EMERGENCY MEDICAL GROUP
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90813-3321
Practice Address - Country:US
Practice Address - Phone:562-491-9762
Practice Address - Fax:562-491-9264
Is Sole Proprietor?:No
Enumeration Date:2008-07-10
Last Update Date:2020-04-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IDM-15012207P00000X
ORMD197782207P00000X
CA390200000X
CAA110195207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program