Provider Demographics
NPI:1689974651
Name:DIAZ, ANALILIA
Entity Type:Individual
Prefix:
First Name:ANALILIA
Middle Name:
Last Name:DIAZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1752 E AVENUE J4
Mailing Address - Street 2:APT. C
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93535-5096
Mailing Address - Country:US
Mailing Address - Phone:323-776-7272
Mailing Address - Fax:
Practice Address - Street 1:13177 RAMONA BLVD
Practice Address - Street 2:STE. C
Practice Address - City:IRWINDALE
Practice Address - State:CA
Practice Address - Zip Code:91706-3855
Practice Address - Country:US
Practice Address - Phone:626-960-4020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-25
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner