Individual
DR. CONNOR DERYL DIETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, FRCPC
Contact information
Practice address
675 NELSON RISING LANE, SUITE 190, SAN FRANCISCO, CA 94158
(415) 866-6835
Mailing address
675 NELSON RISING LANE, SUITE 190, SAN FRANCISCO, CA 94158
(415) 866-6835
Taxonomy
Speciality
Code
Description
License number
State
2084B0040X
Behavioral Neurology & Neuropsychiatry Physician
A198459
CA
2084N0400X
Neurology Physician
Primary
A198459
CA
Other
Enumeration date
08/20/2024
Last updated
08/20/2024
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