Healthcare Provider Details

I. General information

NPI: 1922242973
Provider Name (Legal Business Name): DIASO CHIROPRACTIC PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2009
Last Update Date: 08/22/2024
Certification Date: 08/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4070 WEST ST
CAMBRIA CA
93428
US

IV. Provider business mailing address

4844 N 1ST ST STE 102
FRESNO CA
93726-0529
US

V. Phone/Fax

Practice location:
  • Phone: 805-927-1055
  • Fax: 805-927-1701
Mailing address:
  • Phone: 559-225-1796
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number17464
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. RONALD JOHN DIASO JR.
Title or Position: OWNER
Credential: DC
Phone: 805-927-1055