Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0004X | Dentist Anesthesiologist | 60350 | CA |
NPI | 1619124203 |
---|---|
Provider Name | Dr. Diana Marie Belli |
First Address | Cupertino, CA 95014-4851 |
Second Address | Cupertino, CA 95014-4851 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/08/2008 |
Last Update Date | 12/02/2016 |