Healthcare Provider Details

I. General information

NPI: 1184829442
Provider Name (Legal Business Name): GABRIEL GARCIA-DIAZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: GABRIEL GARCIA-DIAZ M.D.

II. Dates (important events)

Enumeration Date: 06/18/2007
Last Update Date: 04/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3180 COLLINS DR STE A
MERCED CA
95348-3156
US

IV. Provider business mailing address

3180 COLLINS DR STE A
MERCED CA
95348-3156
US

V. Phone/Fax

Practice location:
  • Phone: 209-349-8429
  • Fax: 209-720-0193
Mailing address:
  • Phone: 209-349-8429
  • Fax: 209-720-0193

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberA115417
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License NumberA115417
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: