Provider Demographics
NPI:1558961730
Name:VEYNA, DIEGO ALBERTO
Entity Type:Individual
Prefix:
First Name:DIEGO
Middle Name:ALBERTO
Last Name:VEYNA
Suffix:
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 1:26355 GADING RD
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94544-3211
Mailing Address - Country:US
Mailing Address - Phone:510-586-7195
Mailing Address - Fax:
Practice Address - Street 1:26355 GADING RD
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94544-3211
Practice Address - Country:US
Practice Address - Phone:510-586-7195
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-28
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD5624516172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver