Individual
DEAN M. DIDECH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
227 N JACKSON AVE, SAN JOSE, CA 95116-1603
(408) 347-2030
(408) 347-2192
Mailing address
400 RACE ST, SAN JOSE, CA 95126-3518
(408) 278-3000
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
G35698
CA
2080A0000X
Pediatric Adolescent Medicine Physician
G35698
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G356980
—
CA
Enumeration date
07/15/2006
Last updated
10/10/2007
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