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Organization

DAVID M. DIAZ, DDS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. TERESA D. BATTISTA (MANAGER)
(949) 548-5588
Entity
Organization

Contact information

Practice address
1801 NEWPORT BLVD STE B, COSTA MESA, CA 92627-2701
(949) 548-5588
(949) 548-5731
Mailing address
1801 NEWPORT BLVD, SUITE B, COSTA MESA, CA 92627-2701
(949) 548-5588
(949) 548-5731

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
30642
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
$$$$$$$$$
SOCIAL SECURITY NUMBER
CA
Enumeration date
05/29/2007
Last updated
05/21/2020
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