Individual
DR. DIEGO MECHOSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
15107 VANOWEN ST, VAN NUYS, CA 91405-4542
(818) 902-5771
Mailing address
PO BOX 60400, PASADENA, CA 91116-6400
(310) 462-6215
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A84467
CA
2080P0203X
Pediatric Critical Care Medicine Physician
A84467
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A844670
—
CA
Enumeration date
06/24/2006
Last updated
01/05/2024
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