Dietz, Jonathan

Dietz, Jonathan is an sole proprietor health care provider with primary practice located at 540 D St 2, San Rafael CA 94901-3867. He recently has only one registered license in Allopathic & Osteopathic Physicians / Adult Medicine, which is considered as his primary health care specialty. Dietz, Jonathan can be contacted via phone (415) 459-7416.

Contact Information

Primary practice address
540 D St 2 San Rafael CA 94901-3867
Phone: (415) 459-7416
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Adult Medicine 207QA0505X 20A7626 California

Profile Details

NPI number 1366566499
LBN Legal business name Dietz, Jonathan
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 16th, 2007
Last updated Jul 8th, 2007 - about 17 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 1366566499 NPPES
New Mexico Other 09171981 SON'S BIRTH

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