Provider Demographics
NPI:1114690252
Name:BOJORQUEZ, DIANA V (MA)
Entity Type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:V
Last Name:BOJORQUEZ
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:DIANA
Other - Middle Name:V
Other - Last Name:GUTIERREZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1355 S HILL ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90015-3012
Mailing Address - Country:US
Mailing Address - Phone:213-389-5820
Mailing Address - Fax:
Practice Address - Street 1:1355 S HILL ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90015-3012
Practice Address - Country:US
Practice Address - Phone:213-389-5820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-26
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program