Healthcare Provider Details

I. General information

NPI: 1154612729
Provider Name (Legal Business Name): DIANA GELI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2011
Last Update Date: 04/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2451 FILLINGIM ST, 1ST FLOOR, UMC UNIVERSITY OF SOUTH ALABAMA, DEPARTMENT OF PATHOLOGY
MOBILE AL
36617-2293
US

IV. Provider business mailing address

16303 WILLOWMIST CT
CHINO HILLS CA
91709-6116
US

V. Phone/Fax

Practice location:
  • Phone: 251-471-7786
  • Fax: 251-471-7884
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: