MEDICARE: TANYA L DIEGEL DO

Medicare Provider Information

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	7955	ND

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0123522	OTHER	ND	MEDICA #
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	137116	OTHER	ND	UCARE #
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	26072	OTHER	ND	NDBS #
6	46520	OTHER	ND	LHS #
7	323S2DI	OTHER	ND	MNBS #
8	990549	OTHER	ND	AMERICA'S PPO/ARAZ #
9	323S3DI	OTHER	ND	MNBS #
10	DA9061017665	OTHER	ND	PREFERRED ONE #
11	0123521	OTHER	ND	MEDICA #
12	26071	OTHER	ND	NDBS #
13	HP30667	OTHER	ND	HEALTHPARTNERS #
14	1014638	OTHER	ND	MEDICA #
15	323S4DI	OTHER	ND	MNBS #

NPI Number	:	1780629311
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TANYA L DIEGEL DO

Provider Business Mailing Address
First Line	:	1702 UNIVERSITY DR S
Second Line	:
City	:	FARGO
State	:	ND
Zip	:	58103-4940
Country	:	US
Telephone Number	:
Fax Number	:	701-253-5402

Provider Business Practice Location Address
First Line	:	132 4TH AVE NE
Second Line	:
City	:	VALLEY CITY
State	:	ND
Zip	:	58072-3056
Country	:	US
Telephone Number	:	701-845-8060
Fax Number	:

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

Provider Enumeration Date	:	06/18/2006
Last Update Date	:	03/07/2018

200 COTTAGE AVE , STE 101
MANTECA, CA
95336-4935

Practice Phone: 209-239-2197
Practice Fax: 209-239-7672