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Individual
MR. MARK JASON DIAZ
Active
Individual
MR. MARK JASON DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C, MS, MPH
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
54564
CA
363AS0400X
Surgical Physician Assistant
54564
CA
Other
Enumeration date
06/21/2017
Last updated
07/03/2017
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