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Organization
GERVACIO D DIAZ III MD INC
Active
Organization
GERVACIO D DIAZ III MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GERVACIO D DIAZ III MD (PRESIDENT)
(209) 529-8506
Entity
Organization
Contact information
Practice address
2013 COFFEE RD, MODESTO, CA 95355-2405
(209) 529-8506
(209) 529-8524
Mailing address
2013 COFFEE RD, MODESTO, CA 95355-2405
(209) 529-8506
(209) 529-8524
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A69801
CA
Other
Enumeration date
11/15/2006
Last updated
03/13/2023
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