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NPI Code Detail

MEDICARE: DIANA MCCAFFERTY PA-C

MEDICARE: DIANA MCCAFFERTY PA-C
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
1363AS0400XSurgical Physician Assistant59379CA
2363A00000XPhysician Assistant59379CA
3390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1194369116
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIANA MCCAFFERTY PA-C
Provider Business Mailing Address
First Line : PO BOX 31396
Second Line :
City : WALNUT CREEK
State : CA
Zip : 94598-8396
Country : US
Telephone Number : 925-939-8585
Fax Number : 925-933-2709
Provider Business Practice Location Address
First Line : 4000 DUBLIN BLVD STE 100
Second Line :
City : DUBLIN
State : CA
Zip : 94568-3122
Country : US
Telephone Number : 800-934-8099
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2019
Last Update Date : 06/23/2022

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Directions to “ DIANA MCCAFFERTY PA-C” Practice Location

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