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General NPI Number Information
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NPI Number | 1063757474
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Entity Type | Organization
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Legal Business Name | N. CHARLES DIAKON D.O. A.P.C
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Dates
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Enumeration Date | 12/11/2012
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Last Update Date | 12/11/2012
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Provider Practice Location Address
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Address Line | 3020 BEARD RD
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City | NAPA
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State | CA
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Zip | 94558-3442
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Country | US
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Telephone | 707-252-1393
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Fax | 707-257-0923
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Provider Business Mailing Address
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Address Line | 3020 BEARD RD
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City | NAPA
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State | CA
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Zip | 94558-3442
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Country | US
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Telephone | 707-252-1393
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Fax | 707-257-0923
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Authorized Official
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Title or Position | DR./OWNER
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Name | DR. N. CHARLES DIAKON
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Credential | D,O.
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Telephone | 707-252-1393
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 20A4443
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License Number State | CA
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