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Individual

MS. CARMEN G DIAZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
4920 AVALON BLVD, LOS ANGELES, CA 90011-4004
(323) 235-5035
Mailing address
PO BOX 1088, PARAMOUNT, CA 90723-1088
(310) 919-8209

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
22144
CA

Other

Enumeration date
03/12/2012
Last updated
03/22/2012
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