Organization
DIABLO NEUROSURGICAL MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERENCE CHEN MD (PRESIDENT)
(925) 937-0404
Entity
Organization
Contact information
Practice address
122 LA CASA VIA STE 222, WALNUT CREEK, CA 94598-3014
(925) 937-0404
(925) 937-1340
Mailing address
122 LA CASA VIA STE 222, WALNUT CREEK, CA 94598-3014
(925) 937-0404
(925) 937-1340
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C41006
RAILROAD MEDICARE
—
01
—
ZZZ72795Z
BLUE SHIELD OF CA
—
Enumeration date
08/14/2006
Last updated
01/08/2025
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