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NPI Code Detail

MEDICARE: CHRISTIAN ANTHONY DIAZ

MEDICARE: CHRISTIAN ANTHONY DIAZ
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
1104100000XSocial WorkerASW135323CA

General Provider Information

NPI Number : 1356758056
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTIAN ANTHONY DIAZ
Provider Business Mailing Address
First Line : 2814 HOPE ST APT A
Second Line :
City : HUNTINGTON PARK
State : CA
Zip : 90255-6040
Country : US
Telephone Number : 323-536-0353
Fax Number :
Provider Business Practice Location Address
First Line : 2330 BEVERLY BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90057-2220
Country : US
Telephone Number : 213-381-0534
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2014
Last Update Date : 12/09/2025

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Directions to “ CHRISTIAN ANTHONY DIAZ ” Practice Location

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