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Individual

IRA A DIAMOND

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
425 W BONITA AVE STE 110, SAN DIMAS, CA 91773-2543
(909) 599-0981
(909) 592-0738
Mailing address
425 W BONITA AVE STE 110, SAN DIMAS, CA 91773-2543
(909) 599-0981
(909) 592-0738

Taxonomy

Speciality
Code
Description
License number
State
213EP0504X
Public Medicine Podiatrist
Primary
E2340
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000E23400
CA
Enumeration date
02/15/2007
Last updated
04/15/2008
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