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Organization

MEDICINA FAMILIAR

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOSE MANUEL GONZALEZ-DIAZ MD (OWNER)
(818) 896-2999
Entity
Organization

Contact information

Practice address
13500 VAN NUYS BLVD, PACOIMA, CA 91331
(818) 896-2999
(818) 896-8449
Mailing address
13500 VAN NUYS BLVD, PACOIMA, CA 91331-3028
(818) 896-2999
(818) 896-8449

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
A41311
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
GR0086101
CA
Enumeration date
10/04/2006
Last updated
05/22/2008
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