Provider Demographics
NPI:1174668065
Name:DIAMOND, WILLIAM STUART (OD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:STUART
Last Name:DIAMOND
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:6500 DUBLIN BLVD
Mailing Address - Street 2:#F
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-3150
Mailing Address - Country:US
Mailing Address - Phone:925-828-7730
Mailing Address - Fax:925-828-2531
Practice Address - Street 1:6500 DUBLIN BLVD
Practice Address - Street 2:#F
Practice Address - City:DUBLIN
Practice Address - State:CA
Practice Address - Zip Code:94568-3150
Practice Address - Country:US
Practice Address - Phone:925-828-7730
Practice Address - Fax:925-828-2531
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA5654T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAT10072Medicare UPIN