Individual
CHASE DIEGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3095 OLD CONEJO RD STE 200, THOUSAND OAKS, CA 91320-2130
(888) 367-1850
Mailing address
PO BOX 6542, SANTA MARIA, CA 93456-6542
(805) 479-1349
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
CA
Other
Enumeration date
09/11/2023
Last updated
06/10/2024
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