Individual
DR. DIANE MOSSER HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1235 BUENA VISTA ST, DUARTE, CA 91010-2408
(626) 359-8145
(626) 359-4116
Mailing address
1235 BUENA VISTA ST, DUARTE, CA 91010-2408
(626) 359-8145
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
08738T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1697023
—
CA
05
—
SD0087381
—
CA
Enumeration date
12/08/2006
Last updated
07/29/2009
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