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General NPI Number Information
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NPI Number | 1477037471
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Entity Type | Individual
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Provider Name | LISA DIAZ RRT
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Gender | Female
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Dates
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Enumeration Date | 09/17/2018
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Last Update Date | 09/17/2018
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Provider Practice Location Address
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Address Line | 13651 CANTARA ST
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City | PANORAMA CITY
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State | CA
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Zip | 91402
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Country | US
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Telephone | 818-375-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 29969 MULEDEER LN
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City | CASTAIC
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State | CA
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Zip | 91384-4503
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Country | US
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Telephone | 760-549-3446
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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 | 227900000X
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Taxonomy Name | Registered Respiratory Therapist
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License Number | 26739
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License Number State | CA
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