Individual
JOSE MANUEL GONZALEZ-DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
13500 VAN NUYS BLVD, PACOIMA, CA 91331
(818) 896-2999
(818) 896-8449
Mailing address
13500 VAN NUYS BLVD, PACOIMA, CA 91331
(818) 896-2999
(818) 896-8449
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
A41311
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0086101
—
CA
Enumeration date
09/27/2006
Last updated
07/08/2007
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