Diaz, Diego F

Diaz, Diego F is an individual health care provider with primary practice located at 4920 N Interstate Ave , Portland OR 97217-3653. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Diaz, Diego F can be contacted via phone (503) 215-3300.

Contact Information

Primary practice address
4920 N Interstate Ave Portland OR 97217-3653
Phone: (503) 215-3300
Fax: (503) 215-3350
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 11014152A Indiana
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X MD159017 Oregon
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD159017 Oregon

Profile Details

NPI number 1407019532
LBN Legal business name Diaz, Diego F
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 9th, 2008
Last updated Feb 4th, 2022 - about 2 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 1407019532 NPPES
Oregon MEDICAID 500649902

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