Healthcare Provider Details

I. General information

NPI: 1740424480
Provider Name (Legal Business Name): DIANA LIBERTAD ARTEAGA FALCONI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DIANA LIBERTAD ARTEAGA MD

II. Dates (important events)

Enumeration Date: 04/24/2009
Last Update Date: 03/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2110 PROFESSIONAL DRIVE, SUITE 120
ROSEVILLE CA
95661
US

IV. Provider business mailing address

3400 DATA DRIVE PHYSICIAN SUPPORT SERVICES
RANCHO CORDOVA CA
95670-7956
US

V. Phone/Fax

Practice location:
  • Phone: 916-536-2500
  • Fax: 916-780-3904
Mailing address:
  • Phone: 916-379-2948
  • Fax: 916-858-7065

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA118646
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: