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NPI Code Detail

MEDICARE: DR. PAUL R DIAZ M.D.

MEDICARE: DR. PAUL R DIAZ M.D.
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
1207L00000XAnesthesiology PhysicianMD25370OR

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00624944OTHERORRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1699766311
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PAUL R DIAZ M.D.
Provider Business Mailing Address
First Line : PO BOX 35147
Second Line : #1801
City : SEATTLE
State : WA
Zip : 98124-5147
Country : US
Telephone Number : 503-299-9906
Fax Number : 503-225-9002
Provider Business Practice Location Address
First Line : 707 SW WASHINGTON ST
Second Line : STE 700
City : PORTLAND
State : OR
Zip : 97205-3536
Country : US
Telephone Number : 503-299-9906
Fax Number : 503-225-9002
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/02/2005
Last Update Date : 10/15/2018

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Directions to “ DR. PAUL R DIAZ M.D.” Practice Location

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