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General NPI Number Information
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NPI Number | 1740552710
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Entity Type | Organization
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Legal Business Name | DIABLO DIGESTIVE CARE, INC.
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Dates
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Enumeration Date | 02/06/2012
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Last Update Date | 02/06/2012
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Provider Practice Location Address
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Address Line | 400 TAYLOR BLVD STE 304
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City | PLEASANT HILL
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State | CA
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Zip | 94523-2160
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Country | US
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Telephone | 925-363-0069
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Fax | 925-363-0077
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Provider Business Mailing Address
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Address Line | 400 TAYLOR BLVD STE 304
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City | PLEASANT HILL
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State | CA
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Zip | 94523-2160
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Country | US
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Telephone | 925-363-0069
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Fax | 925-363-0077
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Authorized Official
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Title or Position | M.D.
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Name | DR. PREMJIT CHAHAL
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Credential | M.D.
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Telephone | 925-363-0069
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | A78375
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License Number State | CA
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