Provider Demographics
NPI:1184829442
Name:GARCIA-DIAZ, GABRIEL (MD)
Entity type:Individual
Prefix:DR
First Name:GABRIEL
Middle Name:
Last Name:GARCIA-DIAZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:GABRIEL
Other - Middle Name:
Other - Last Name:GARCIA-DIAZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:3180 COLLINS DR STE A
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95348-3156
Mailing Address - Country:US
Mailing Address - Phone:209-349-8429
Mailing Address - Fax:209-720-0193
Practice Address - Street 1:3180 COLLINS DR STE A
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95348-3156
Practice Address - Country:US
Practice Address - Phone:209-349-8429
Practice Address - Fax:209-720-0193
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-18
Last Update Date:2018-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA115417207X00000X, 207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery