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General NPI Number Information
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NPI Number | 1588373922
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Entity Type | Organization
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Legal Business Name | JOSE J DIAZ MD INC
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Dates
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Enumeration Date | 11/15/2022
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Last Update Date | 11/15/2022
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Provider Practice Location Address
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Address Line | 7720 RANCHO SANTA FE RD #225
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City | CARLSBAD
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State | CA
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Zip | 92009
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Country | US
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Telephone | 626-524-3865
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Fax |
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Provider Business Mailing Address
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Address Line | 147 W ROUTE 66 # 650
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City | GLENDORA
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State | CA
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Zip | 91740-6208
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Country | US
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Telephone | 626-524-3865
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOSE J DIAZ
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Credential | MD
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Telephone | 626-524-3865
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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 |
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License Number State |
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