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NPI 1396310678

NPI 1396310678 : HARRY G NAZARIO DIAZ : FRESNO, CA

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General NPI Number Information
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    NPI Number           |    1396310678
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    Entity Type          |    Individual 
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    Provider Name        |    HARRY G NAZARIO DIAZ
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    05/20/2021
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    Last Update Date     |    06/17/2025
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Provider Practice Location Address
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    Address Line         |    1303 E HERNDON AVE 
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    City                 |    FRESNO
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    State                |    CA
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    Zip                  |    93720-3309
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    Country              |    US
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    Telephone            |    559-450-3000
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    5655 N MILLBROOK AVE 
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    City                 |    FRESNO
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    State                |    CA
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    Zip                  |    93710-6404
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    Country              |    US
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    Telephone            |    787-646-6307
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207P00000X
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    Taxonomy Name        |    Emergency Medicine Physician
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    License Number       |    A200218
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    License Number State |    CA
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Taxonomy #2
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    Taxonomy Code        |    390200000X
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    Taxonomy Name        |    Student in an Organized Health Care Education/Training Program
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    License Number       |    
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    License Number State |    
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