Organization
DIANA BREISTER GHOSH, M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DIANA MARIE BREISTER GHOSH M.D. (PHYSICIAN & SURGEON/PRESIDENT)
(619) 286-6446
Entity
Organization
Contact information
Practice address
6386 ALVARADO CT, SUITE 330, SAN DIEGO, CA 92120-4905
(619) 286-6446
(619) 286-1618
Mailing address
6386 ALVARADO CT, SUITE 330, SAN DIEGO, CA 92120-4905
(619) 286-6446
(619) 286-1618
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
A55510
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A555101
—
CA
01
—
1629050943
NPI TYPE 1
—
01
—
A55510
MEDICAL LICENSE
CA
Enumeration date
11/05/2010
Last updated
11/05/2010
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