Individual
LAURA DIANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
65 NEILSON ST STE 101, WATSONVILLE, CA 95076-2491
(831) 786-1457
(831) 786-1458
Mailing address
65 NEILSON ST STE 101, WATSONVILLE, CA 95076-2491
(831) 786-1457
(831) 786-1458
Taxonomy
Speciality
Code
Description
License number
State
207VC0200X
Critical Care Medicine (Obstetrics & Gynecology) Physician
Primary
G075508
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G755080
MEDI-CAL
CA
Enumeration date
03/08/2007
Last updated
07/08/2007
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