Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 95018402 | CA |
N | 363LA2200X | Nurse Practitioner - Adult Health | 95018402 | CA |
N | 363LG0600X | Nurse Practitioner - Gerontology | 95018402 | CA |
NPI | 1043980980 |
---|---|
Provider Name | Oscar A Diaz |
First Address | Mission Hills, CA 91346-9602 |
Second Address | Mission Hills, CA 91346 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2021 |
Last Update Date | 03/11/2021 |