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NPI Code Detail

MEDICARE: MR. DIEGO SOTO

MEDICARE: MR. DIEGO SOTO
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1689719692
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DIEGO SOTO
Provider Business Mailing Address
First Line : 16667 LEMARSH ST
Second Line :
City : NORTH HILLS
State : CA
Zip : 91343-1133
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4928 LANKERSHIM BLVD
Second Line :
City : NORTH HOLLYWOOD
State : CA
Zip : 91601-4443
Country : US
Telephone Number : 818-763-7919
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/20/2007
Last Update Date : 07/08/2007

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