Individual
DR. JOHN DIECKHOFF JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
16200 SAND CANYON AVE, IRVINE, CA 92618-3714
(949) 610-7245
(657) 241-7720
Mailing address
PO BOX 3589, NEWPORT BEACH, CA 92659-8589
(657) 241-3600
(657) 241-7708
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A103281
CA
208M00000X
Hospitalist Physician
Primary
A103281
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DG077Y
MEDICARE PIN
CA
01
—
P00959916
MEDICARE RAILROAD
CA
Enumeration date
11/28/2007
Last updated
07/21/2022
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