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Individual

JORGE A DIAZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4060 E WHITTIER BLVD, LOS ANGELES, CA 90023-2526
(323) 268-5514
Mailing address
PO BOX 11600, WESTMINSTER, CA 92685-1600
(562) 809-3541
(562) 468-0347

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
G44167
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00G441670
CA
Enumeration date
04/28/2006
Last updated
08/26/2008
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