Diamond, Ira A

Diamond, Ira A is an sole proprietor health care provider with primary practice located at 425 W Bonita Ave Ste 110 , San Dimas CA 91773-2543. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Public Medicine, which is considered as his primary health care specialty. Diamond, Ira A can be contacted via phone (909) 599-0981.

Contact Information

Primary practice address
425 W Bonita Ave Ste 110 San Dimas CA 91773-2543
Fax: (909) 592-0738
Website:

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Public Medicine 213EP0504X E2340 California

Profile Details

NPI number 1295878247
LBN Legal business name Diamond, Ira A
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 15th, 2007
Last updated Apr 15th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295878247 NPPES
California MEDICAID 000E23400

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