Dr. Diana Marcela Medina
Oral and Maxillofacial Surgeon
11980 San Vicente Blvd Suite 505
Los Angeles
, California 90049-5012
Dr. Diana Marcela Medina
Oral and Maxillofacial Surgeon
11980 San Vicente Blvd Suite 505
Los Angeles
, California 90049-5012
(310) 490-6674
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About
Features
Specialties
- Oral and Maxillofacial Surgeon
Languages spoken
- English
Location
First Address
- Dr. Diana Marcela Medina
- 10620 Eastborne Ave Apt # 302
- Los Angeles, CA
- Zip : 90024-5985
- Phone : (310) 490-6674
Second Address
- Dr. Diana Marcela Medina
- 11980 San Vicente Blvd Suite 505
- Los Angeles, CA
- Zip : 90049-5012
- Fax : (310) 820-6041
- Phone : (310) 820-6691
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223S0112X | Oral and Maxillofacial Surgeon | 50643 | CA |
National Provider Identifier
| NPI | 1003827551 |
|---|---|
| Provider Name | Dr. Diana Marcela Medina |
| First Address | Los Angeles, CA 90024-5985 |
| Second Address | Los Angeles, CA 90049-5012 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 10/08/2006 |
| Last Update Date | 08/07/2007 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.