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Individual

ANTONIO J DIAZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
3915 E 2ND ST, LOS ANGELES, CA 90063-3613
(323) 262-2354
Mailing address
PO BOX 63067, LOS ANGELES, CA 90063-0067
(323) 262-2354

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
13947
NV
183500000X
Pharmacist
Primary
RPH 47901
CA

Other

Enumeration date
10/12/2012
Last updated
10/12/2012
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