Individual
DEREK DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
2821 S CASCADES TRL, ONTARIO, CA 91761-7234
(909) 732-0197
Mailing address
2821 S CASCADES TRL, ONTARIO, CA 91761-7234
(909) 732-0197
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
95021897
CA
Other
Enumeration date
09/13/2022
Last updated
09/13/2022
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