Organization
DIANE LI MD, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAN LI M.D. (OWNER)
(805) 490-8390
Entity
Organization
Contact information
Practice address
1000 NEWBURY RD, SUITE 115, NEWBURY PARK, CA 91320-6435
(805) 490-8390
Mailing address
1000 NEWBURY RD, SUITE 115, NEWBURY PARK, CA 91320-6435
(805) 490-8390
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A86068
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A86068
CALIFORNIA MEDICAL LICENSE
CA
Enumeration date
08/01/2013
Last updated
08/01/2013
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