1033434923 NPI number — DR. PARKER ANDREW DUNCAN DIAZ MD, MPH, FAAFP

Table of content: DR. PARKER ANDREW DUNCAN DIAZ MD, MPH, FAAFP (NPI 1033434923)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033434923 NPI number — DR. PARKER ANDREW DUNCAN DIAZ MD, MPH, FAAFP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DUNCAN DIAZ
Provider First Name:
PARKER
Provider Middle Name:
ANDREW
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD, MPH, FAAFP
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DUNCAN
Provider Other First Name:
PARKER
Provider Other Middle Name:
ANDREW
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD, MPH
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1033434923
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/18/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3569 ROUND BARN CIR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SANTA ROSA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95403
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
707-303-3600
Provider Business Mailing Address Fax Number:
707-583-8796

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
751 LOMBARDI CT
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SANTA ROSA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95407-6798
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
707-547-2222
Provider Business Practice Location Address Fax Number:
707-547-2229
Provider Enumeration Date:
04/02/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207QA0401X , with the licence number:  A118268 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com