Provider Demographics
NPI:1326558347
Name:LEPE, DIEGO ALBERTO I
Entity Type:Individual
Prefix:MR
First Name:DIEGO
Middle Name:ALBERTO
Last Name:LEPE
Suffix:I
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9015 MURRAY AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:GILROY
Mailing Address - State:CA
Mailing Address - Zip Code:95020-3617
Mailing Address - Country:US
Mailing Address - Phone:408-665-4908
Mailing Address - Fax:408-842-0383
Practice Address - Street 1:115 MADRONE AVE
Practice Address - Street 2:
Practice Address - City:MORGAN HILL
Practice Address - State:CA
Practice Address - Zip Code:95037-9227
Practice Address - Country:US
Practice Address - Phone:408-665-4908
Practice Address - Fax:408-842-0383
Is Sole Proprietor?:No
Enumeration Date:2017-10-04
Last Update Date:2017-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator