Individual
GUMARO DIAZ III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
326 LELAH AVE, MODESTO, CA 95350-4416
(408) 209-6175
Mailing address
326 LELAH AVE, MODESTO, CA 95350-4416
(408) 209-6175
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
08/02/2016
Last updated
08/02/2016
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