Individual
JOSEPH ANTHONY DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
200 MERCY CIRCLE, CAMP PENDLETON, CA 92055
(910) 574-7366
Mailing address
200 WEST MERCY CIRCLE, CAMP PENDLETON, CA 92055
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
—
—
208600000X
Surgery Physician
Primary
0101268149
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
171000000X
TRICARE
—
Enumeration date
02/26/2018
Last updated
08/29/2024
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