Individual
MONICA DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
9916 SAN JUAN AVE, SOUTH GATE, CA 90280-6108
(323) 564-1100
(323) 564-1133
Mailing address
9916 SAN JUAN AVE, SOUTH GATE, CA 90280-6108
(323) 564-1100
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA 20566
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA 20566
LICENSE
CA
Enumeration date
01/06/2010
Last updated
02/04/2016
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