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Organization

DIANE G. OLIVER, M.D.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DIANE G OLIVER MD (PRESIDENT)
(530) 542-3000
Entity
Organization

Contact information

Practice address
2170 SOUTH AVE, SOUTH LAKE TAHOE, CA 96150-7026
(530) 542-3000
Mailing address
PO BOX 10076, VAN NUYS, CA 91410-0076
(805) 578-8300
(805) 578-8950

Taxonomy

Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
LAB37576F
CA
Enumeration date
04/03/2006
Last updated
07/13/2007
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