| Mario A Diaz-gomez, M.d., A Professional Corporation | |
|
360 E 7th St Ste L Upland CA 91786-6701 | |
| (909) 303-3074 | |
| (909) 303-3090 |
| Full Name | Mario A Diaz-gomez, M.d., A Professional Corporation |
|---|---|
| Speciality | Family Medicine |
| Location | 360 E 7th St Ste L, Upland, California |
| Authorized Official Name and Position | Mario A Diaz-gomez (PHYSICIAN) |
| Authorized Official Contact | 9093033074 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mario A Diaz-gomez, M.d., A Professional Corporation 360 E 7th St Suite D Upland CA 91786-6701 Ph: (909) 981-2500 | Mario A Diaz-gomez, M.d., A Professional Corporation 360 E 7th St Ste L Upland CA 91786-6701 Ph: (909) 303-3074 |
| NPI Number | 1801283916 |
|---|---|
| Provider Enumeration Date | 04/16/2015 |
| Last Update Date | 12/22/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801283916 | NPI | - | NPPES |
| G564320 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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