Provider Demographics
NPI:1033389903
Name:HYLTON, DIANA JEAN (MD)
Entity Type:Individual
Prefix:DR
First Name:DIANA
Middle Name:JEAN
Last Name:HYLTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 W OLIVE AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95348
Mailing Address - Country:US
Mailing Address - Phone:209-723-2132
Mailing Address - Fax:209-723-3017
Practice Address - Street 1:750 W OLIVE AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95348
Practice Address - Country:US
Practice Address - Phone:209-723-2132
Practice Address - Fax:209-723-3017
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-07
Last Update Date:2008-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA412252084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A412250Medicare PIN
CAA49332Medicare UPIN