Provider Demographics
NPI:1346251055
Name:DIASO, RONALD JOHN (DC)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:JOHN
Last Name:DIASO
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 1:4070 WEST ST
Mailing Address - Street 2:
Mailing Address - City:CAMBRIA
Mailing Address - State:CA
Mailing Address - Zip Code:93428-3023
Mailing Address - Country:US
Mailing Address - Phone:559-855-8445
Mailing Address - Fax:559-855-8440
Practice Address - Street 1:29369 AUBERRY RD STE 101
Practice Address - Street 2:
Practice Address - City:PRATHER
Practice Address - State:CA
Practice Address - Zip Code:93651-9784
Practice Address - Country:US
Practice Address - Phone:559-855-8445
Practice Address - Fax:559-855-8440
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2017-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17464111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0174641Medicare ID - Type Unspecified
CAU26594Medicare UPIN