Diaz, Derek Dennis

Diaz, Derek Dennis is an sole proprietor health care provider with primary practice located at 2333 N 6Th St , Grand Junction CO 81501. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Diaz, Derek Dennis can be contacted via phone (970) 298-1782.

Contact Information

Primary practice address
2333 N 6Th St Grand Junction CO 81501
Phone: (970) 298-1782
Fax: (970) 692-8301
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 4748 Colorado

Profile Details

NPI number 1780952614
LBN Legal business name Diaz, Derek Dennis
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 6th, 2011
Last updated May 11th, 2020 - about 6 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 1780952614 NPPES
Colorado MEDICAID 9000143760

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