Individual
DR. DIANA M. ANTONIUCCI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1375 SUTTER ST, STE 208, SAN FRANCISCO, CA 94109-5438
(415) 600-0110
(415) 558-7038
Mailing address
2350 W EL CAMINO REAL FL 2, MOUNTAIN VIEW, CA 94040-6203
(415) 600-0110
(415) 558-7038
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A74113
CA
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
A74113
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0A7411300
—
CA
01
—
A74113
STATE MEDICAL LICENSE
CA
Enumeration date
04/12/2006
Last updated
03/20/2019
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