Healthcare Provider Details

I. General information

NPI: 1578484804
Provider Name (Legal Business Name): RAFAEL DIAZ M.D., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 SANSOME ST STE A1075
SAN FRANCISCO CA
94104-4448
US

IV. Provider business mailing address

1 SANSOME ST STE A1075
SAN FRANCISCO CA
94104-4448
US

V. Phone/Fax

Practice location:
  • Phone: 925-272-9636
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: RAFAEL DIAZ
Title or Position: PRESIDENT
Credential: MD
Phone: 925-272-9636