Provider Demographics
NPI:1326043027
Name:BELO, DIOGO S (MD)
Entity Type:Individual
Prefix:DR
First Name:DIOGO
Middle Name:S
Last Name:BELO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9610 GRANITE RIDGE DR
Mailing Address - Street 2:STE B
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-2684
Mailing Address - Country:US
Mailing Address - Phone:858-810-8000
Mailing Address - Fax:858-268-1911
Practice Address - Street 1:340 4TH AVE
Practice Address - Street 2:STE 4
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-3813
Practice Address - Country:US
Practice Address - Phone:619-427-1144
Practice Address - Fax:619-427-1185
Is Sole Proprietor?:No
Enumeration Date:2005-06-17
Last Update Date:2016-03-02
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Provider Licenses
StateLicense IDTaxonomies
CAC41850207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C418500Medicaid
CAD38229Medicare UPIN
CA00C418500Medicaid