Individual
JONATHAN DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
8730 SANTA MONICA BLVD STE G, WEST HOLLYWOOD, CA 90069-4547
(310) 659-2740
(310) 959-2748
Mailing address
8730 SANTA MONICA BLVD STE G, WEST HOLLYWOOD, CA 90069-4547
(310) 659-2740
(310) 959-2748
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA47990
CA
Other
Enumeration date
05/30/2016
Last updated
05/30/2016
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