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NPI Code Detail

MEDICARE: DR. MICHAEL J DIAMENT MD

MEDICARE: DR. MICHAEL J DIAMENT MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology PhysicianC37303CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
100C373030OTHERCAMEDI-CAL

General Provider Information

NPI Number : 1053394536
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL J DIAMENT MD
Provider Business Mailing Address
First Line : 3520 ST SUSAN PL
Second Line :
City : LOS ANGELES
State : CA
Zip : 90066-2112
Country : US
Telephone Number : 310-397-0219
Fax Number : 310-745-0884
Provider Business Practice Location Address
First Line : 1600 W AVENUE J
Second Line :
City : LANCASTER
State : CA
Zip : 93534-2814
Country : US
Telephone Number : 805-577-2179
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2005
Last Update Date : 07/08/2007

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