Individual
MR. DMITRI DE LA CRUZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
311 W I ST, LOS BANOS, CA 93635-3479
(209) 826-2222
(209) 826-2599
Mailing address
311 W I ST, LOS BANOS, CA 93635-3479
(209) 826-2222
(209) 826-2599
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
G54368
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G54368
LICENSE #
—
Enumeration date
07/31/2006
Last updated
06/11/2025
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