Individual
VICTOR DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPSW
Contact information
Practice address
1421 LUISA ST STE PANDQ, SANTA FE, NM 87505-4073
(505) 603-7003
(505) 603-7003
Mailing address
1421 LUISA ST STE PANDQ, SANTA FE, NM 87505-4073
(505) 603-7003
(505) 603-7003
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
1853
NM
Other
Enumeration date
04/09/2025
Last updated
04/09/2025
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