Individual
JORGE RAUL DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2334 GRANDEUR AVE, ALTADENA, CA 91001-5534
(626) 353-8241
Mailing address
1816 S FIGUEROA ST FL 6, LOS ANGELES, CA 90015-3422
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
—
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
12/08/2022
Last updated
05/12/2025
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