Provider Demographics
NPI:1922378116
Name:GIRNITA, DIANA M (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:DIANA
Middle Name:M
Last Name:GIRNITA
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3896 DUNCAN PL
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94306-4548
Mailing Address - Country:US
Mailing Address - Phone:513-917-0908
Mailing Address - Fax:
Practice Address - Street 1:877 W FREMONT AVE STE N1
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94087-2332
Practice Address - Country:US
Practice Address - Phone:650-479-4076
Practice Address - Fax:650-263-7265
Is Sole Proprietor?:No
Enumeration Date:2012-01-05
Last Update Date:2021-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.122228207R00000X, 207RR0500X
CAA167653207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0106554Medicaid
OHH338910Medicare PIN