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General NPI Number Information
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NPI Number | 1801235700
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Entity Type | Individual
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Provider Name | DIANA LONDONO
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Gender | Female
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Dates
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Enumeration Date | 06/24/2013
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Last Update Date | 09/15/2021
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Provider Practice Location Address
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Address Line | 46100 WASHINGTON ST
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City | LA QUINTA
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State | CA
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Zip | 92253-2042
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Country | US
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Telephone | 760-340-0528
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Fax | 760-674-1590
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Provider Business Mailing Address
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Address Line | 46100 WASHINGTON ST
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City | LA QUINTA
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State | CA
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Zip | 92253-2042
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Country | US
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Telephone | 760-340-0528
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Fax | 760-674-1590
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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 | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 62054
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 125063912
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | A173775
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License Number State | CA
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