Provider Demographics
NPI:1609958636
Name:CLAIRE T DIEP MD INC
Entity Type:Organization
Organization Name:CLAIRE T DIEP MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CLAIRE
Authorized Official - Middle Name:THUC DUYEN
Authorized Official - Last Name:DIEP
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:510-441-8081
Mailing Address - Street 1:33509 WESTERN AVENUE
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94587
Mailing Address - Country:US
Mailing Address - Phone:510-441-8081
Mailing Address - Fax:510-441-8080
Practice Address - Street 1:33509 WESTERN AVENUE
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:CA
Practice Address - Zip Code:94587
Practice Address - Country:US
Practice Address - Phone:510-441-8081
Practice Address - Fax:510-441-8080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA55900207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A559000Medicaid
00A559001Medicare ID - Type Unspecified
G64788Medicare UPIN