Individual
GIGI DIATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
19634 VENTURA BLVD STE 303, TARZANA, CA 91356-6022
(818) 975-8203
Mailing address
6670 GLADE AVE APT 104, WOODLAND HILLS, CA 91303-2539
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
10964
CA
Other
Enumeration date
08/01/2019
Last updated
08/01/2019
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