Individual
JESUS DIAZ GARCIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
12555 LAKEWOOD BLVD STE F, DOWNEY, CA 90242-2771
(562) 923-4704
Mailing address
45046 PROMISE RD, LAKE ELSINORE, CA 92532-1500
(909) 272-3221
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
51544
CA
Other
Enumeration date
11/24/2021
Last updated
11/24/2021
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