Individual
MS. DIANA ESTHER MEDINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
31225 WATER AVE, NUEVO, CA 92567-9760
(951) 448-2767
Mailing address
43449 EDITH WAY, HEMET, CA 92544-1927
(951) 448-2767
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F4997424
DRIVER LICENSE
CA
Enumeration date
10/09/2019
Last updated
09/29/2020
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