Organization
CLINICA MEDICA ECO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSE MANUEL DIAZ M.D. (PRESIDENT/OWNER)
(951) 688-0136
Entity
Organization
Contact information
Practice address
4900 ARLINGTON AVE, RIVERSIDE, CA 92504-2780
(951) 688-0136
(951) 688-0137
Mailing address
4900 ARLINGTON AVE, RIVERSIDE, CA 92504-2780
(951) 688-0136
(951) 688-0137
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
A76805
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16852
PA LICENSE NUMBER
CA
01
—
A76805
MEDICAL LICENSE NUMBER
CA
Enumeration date
09/12/2016
Last updated
09/12/2016
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