Provider Information for 1275810442
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CLAUDIA DIAZ
Sex: Female
NPI: 1275810442
Last Updated: 2021-03-11
Certification Date: 2021-03-11
Certification Date: 2021-03-11
Details
| Name | Value | ||||||||||||
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| NPI | 1275810442 | ||||||||||||
| Enumeration Date | 2011-11-15 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 302 CHERRY LN STE 101 MANTECA, CA 95337-4311 United States Phone: | Fax: | ||||||||||||
| Primary Practice Address | 302 CHERRY LN STE 101 MANTECA, CA 95337-4311 United States Phone: 209-647-7648 | Fax: | ||||||||||||
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