Provider Demographics
NPI:1659032506
Name:DIAMOND PREVENTIVE CARE INC.
Entity Type:Organization
Organization Name:DIAMOND PREVENTIVE CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:SANFORD
Authorized Official - Middle Name:
Authorized Official - Last Name:GUAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-688-1018
Mailing Address - Street 1:3321 TYLER AVE
Mailing Address - Street 2:
Mailing Address - City:EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91731-3101
Mailing Address - Country:US
Mailing Address - Phone:626-688-1048
Mailing Address - Fax:
Practice Address - Street 1:3321 TYLER AVE
Practice Address - Street 2:
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91731-3101
Practice Address - Country:US
Practice Address - Phone:626-688-1048
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-04
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care