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Individual

GUSTAVO A. DIAZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
830 JEFFERSON AVE, REDWOOD CITY, CA 94063-1804
(650) 381-0616
Mailing address
100 WILSON RD STE 100, MONTEREY, CA 93940-7885
(831) 649-1000

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
53006
MA
207P00000X
Emergency Medicine Physician
Primary
C54872
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000006706
BMC
MA
01
04-3329195
NORTH AMERICAN PREFERRED
MA
01
053006
TUFTS
MA
01
102531
CIGNA
MA
01
2359897
AETNA
MA
01
24922
HEALTH NEW ENGLAND
MA
05
3000915
MA
01
438822
HARVARD PILGRIM
MA
01
632919
CONNECTICARE
MA
01
J08576
BCBS MA
MA
Enumeration date
04/10/2006
Last updated
03/16/2026
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