Individual
MRS. DONNA BOURGEOIS DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
4030 BIRCH ST STE 107, NEWPORT BEACH, CA 92660-2291
(949) 752-5533
(949) 752-5532
Mailing address
180 CECIL PL APT B, COSTA MESA, CA 92627-6719
(337) 967-2768
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC 33757
CA
Other
Enumeration date
01/25/2017
Last updated
01/25/2017
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