Healthcare Provider Details

I. General information

NPI: 1467209866
Provider Name (Legal Business Name): ANTHONY DIOMINO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2024
Last Update Date: 07/07/2025
Certification Date: 07/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9890 COUNTY FARM RD STE 1
RIVERSIDE CA
92503-3678
US

IV. Provider business mailing address

1700 MOUNT VERNON AVE
BAKERSFIELD CA
93306-4018
US

V. Phone/Fax

Practice location:
  • Phone: 951-358-4700
  • Fax:
Mailing address:
  • Phone: 661-326-2234
  • Fax: 661-862-7684

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number16330
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: