Provider Demographics
NPI:1124216775
Name:DIAMOND, CRAIG HARRY (DC)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:HARRY
Last Name:DIAMOND
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24926 JIM BRIDGER RD
Mailing Address - Street 2:
Mailing Address - City:HIDDEN HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91302-1125
Mailing Address - Country:US
Mailing Address - Phone:818-317-9535
Mailing Address - Fax:
Practice Address - Street 1:23693 CALABASAS RD
Practice Address - Street 2:
Practice Address - City:CALABASAS
Practice Address - State:CA
Practice Address - Zip Code:91302-1502
Practice Address - Country:US
Practice Address - Phone:818-225-5900
Practice Address - Fax:818-225-5905
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-09
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30667111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor