# DIABLO INFECTIOUS DISEASE CONSULTATIVE SERVICE MED GRP INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1952376535
- **Authorized official:** LI KUO KONG MD (PRESIDENT)
- **Authorized official phone:** (925) 463-1318

## Contact information

- **Practice address:** 13851 E 14TH ST STE 308, SAN LEANDRO, CA 94578-2630
- **Practice address phone:** (925) 463-1318
- **Mailing address:** PO BOX 20309, CASTRO VALLEY, CA 94546-8309
- **Mailing address phone:** (925) 463-1318

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RI0200X | Infectious Disease Physician | — | NULL | Yes |
| 207RI0200X | Infectious Disease Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/17/2006
- **Last updated:** 07/24/2023