MEDICARE: PHILIP C DIORIO M.D.

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	152WP0200X	Pediatric Optometrist	GFE8238	CA

General Provider Information

NPI Number	:	1437425196
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PHILIP C DIORIO M.D.

Provider Business Mailing Address
First Line	:	1059 GRANVILLE DR
Second Line	:
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92660-6205
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1059 GRANVILLE DR
Second Line	:
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92660-6205
Country	:	US
Telephone Number	:	949-720-1821
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/27/2012
Last Update Date	:	03/27/2012

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Directions to “ PHILIP C DIORIO M.D.” Practice Location

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