Individual
DR. ETHAN S DIEP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
878 EASTLAKE PKWY STE 1011, CHULA VISTA, CA 91914-4546
(619) 216-4582
(619) 216-4589
Mailing address
878 EASTLAKE PKWY STE 1011, CHULA VISTA, CA 91914-4546
(619) 216-4582
(619) 216-4589
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
14173
CA
Other
Enumeration date
07/14/2011
Last updated
12/01/2021
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