Provider Demographics
NPI:1871002436
Name:CAMPBELL, DIAHNN FUTALAN (MD)
Entity Type:Individual
Prefix:
First Name:DIAHNN
Middle Name:FUTALAN
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DIAHNN
Other - Middle Name:YLAGAN
Other - Last Name:FUTALAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8700 BEVERLY BLVD STE 3622
Mailing Address - Street 2:
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90048-1804
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8700 BEVERLY BLVD.
Practice Address - Street 2:SUITE 3622
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-9003
Practice Address - Country:US
Practice Address - Phone:310-423-7417
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-27
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program