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Individual
IRA A DIAMOND
Active
Individual
IRA A DIAMOND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213EP0504X
Public Medicine Podiatrist
Primary
E2340
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000E23400
—
CA
Enumeration date
02/15/2007
Last updated
04/15/2008
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