Individual
DR. JASON EDWARD DIETZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MBBCHBAO
Contact information
Practice address
4720 VINETA AVE, LA CANADA, CA 91011-2619
(818) 306-6240
Mailing address
51 N 39TH ST, PHILADELPHIA, PA 19104-2640
(215) 662-9990
(215) 243-3297
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
MD470749
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
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Other
Enumeration date
03/23/2017
Last updated
12/15/2020
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