Provider Demographics
NPI:1497738348
Name:NOYES, DIANE K (MD)
Entity Type:Individual
Prefix:DR
First Name:DIANE
Middle Name:K
Last Name:NOYES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 EL DORADO CT
Mailing Address - Street 2:
Mailing Address - City:PASO ROBLES
Mailing Address - State:CA
Mailing Address - Zip Code:93446-1840
Mailing Address - Country:US
Mailing Address - Phone:805-434-4352
Mailing Address - Fax:
Practice Address - Street 1:1100 LAS TABLAS RD
Practice Address - Street 2:
Practice Address - City:TEMPLETON
Practice Address - State:CA
Practice Address - Zip Code:93465-9704
Practice Address - Country:US
Practice Address - Phone:805-434-4352
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-23
Last Update Date:2009-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG86784207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G867840Medicaid
CAG86784OtherMEDICAL LICENSE
CA11152312OtherCAQH
CA00G867840Medicaid
CAAY136ZMedicare PIN