Provider Demographics
NPI:1154448876
Name:FRANCO, CARLO DIAZ (MD)
Entity Type:Individual
Prefix:
First Name:CARLO
Middle Name:DIAZ
Last Name:FRANCO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:CARLO
Other - Middle Name:
Other - Last Name:DIAZ FRANCO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:101 THE CITY DR S
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-3201
Mailing Address - Country:US
Mailing Address - Phone:312-402-1497
Mailing Address - Fax:
Practice Address - Street 1:101 THE CITY DR S
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-3201
Practice Address - Country:US
Practice Address - Phone:144-563-0887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.088478207L00000X
IL336-050313207L00000X
CAC166556207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology