Provider Demographics
NPI:1417446063
Name:DIEC, TUAN CAM (ADMIN ASSISTANT)
Entity Type:Individual
Prefix:
First Name:TUAN
Middle Name:CAM
Last Name:DIEC
Suffix:
Gender:M
Credentials:ADMIN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:767 N HILL ST STE 400B
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90012-2381
Mailing Address - Country:US
Mailing Address - Phone:213-808-1720
Mailing Address - Fax:213-253-0883
Practice Address - Street 1:767 N HILL ST STE 400B
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90012-2381
Practice Address - Country:US
Practice Address - Phone:213-808-1720
Practice Address - Fax:213-253-0883
Is Sole Proprietor?:No
Enumeration Date:2018-05-08
Last Update Date:2018-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator