MEDICARE: DIABLO VALLEY PERFUSION, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	246Z00000X	Other Specialist/Technologist

General Provider Information

NPI Number	:	1225105505
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIABLO VALLEY PERFUSION, INC.

Provider Business Mailing Address
First Line	:	5433 CLAYTON RD
Second Line	:	SUITE K368
City	:	CLAYTON
State	:	CA
Zip	:	94517-1089
Country	:	US
Telephone Number	:	925-672-6936
Fax Number	:	925-672-6936

Provider Business Practice Location Address
First Line	:	5433 CLAYTON RD
Second Line	:	SUITE K368
City	:	CLAYTON
State	:	CA
Zip	:	94517-1089
Country	:	US
Telephone Number	:	925-672-6936
Fax Number	:	925-672-6936

Authorized Official
Title or Position	:	CEO
Name	:	STEVEN J. PRATO
Credential	:	CCP
Telephone Number	:	925-672-6936

Provider Enumeration Date	:	11/29/2006
Last Update Date	:	08/22/2020

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