Individual
ADAM GEMMEL REID DIETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD.
Contact information
Practice address
19950 RINALDI ST, PORTER RANCH, CA 91326-4141
(818) 403-2460
(818) 363-7362
Mailing address
PO BOX 9602, MISSION HILLS, CA 91346-9602
(818) 837-5637
(818) 837-5589
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
A105159
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A1051590
—
CA
Enumeration date
02/17/2007
Last updated
07/10/2012
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