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Individual

ISRAEL DE JESUS DIOSDADO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
HEALTH WORKER II

Contact information

Practice address
2712 MISSION ST, SAN FRANCISCO, CA 94110-3104
(415) 401-2700
(415) 401-2741
Mailing address
2712 MISSION ST, SAN FRANCISCO, CA 94110-3104
(415) 401-2700
(415) 401-2741

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
246RP1900X
Phlebotomy Technician
Primary
CPT 00019019
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
CPT 00019019
STATE LISCENCE PHLEBOTOMIST
CA
Enumeration date
09/04/2014
Last updated
10/03/2014
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