Provider Demographics
NPI:1467683045
Name:DIEBOLD, JOSEPH THOMAS (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:THOMAS
Last Name:DIEBOLD
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 1:21020 HOMESTEAD RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014-0240
Mailing Address - Country:US
Mailing Address - Phone:408-733-3760
Mailing Address - Fax:
Practice Address - Street 1:21020 HOMESTEAD RD
Practice Address - Street 2:SUITE 1
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014-0240
Practice Address - Country:US
Practice Address - Phone:408-733-3760
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-30
Last Update Date:2009-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31303111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor