Provider Demographics
NPI:1336844844
Name:DIABLO MEDICAL SERVICES INC
Entity Type:Organization
Organization Name:DIABLO MEDICAL SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:LIGHTELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-586-2532
Mailing Address - Street 1:895 DISCOVERY BAY BLVD
Mailing Address - Street 2:
Mailing Address - City:DISCOVERY BAY
Mailing Address - State:CA
Mailing Address - Zip Code:94505-9441
Mailing Address - Country:US
Mailing Address - Phone:925-586-2532
Mailing Address - Fax:925-586-2532
Practice Address - Street 1:895 DISCOVERY BAY BLVD
Practice Address - Street 2:
Practice Address - City:DISCOVERY BAY
Practice Address - State:CA
Practice Address - Zip Code:94505-9441
Practice Address - Country:US
Practice Address - Phone:925-586-2532
Practice Address - Fax:925-586-2532
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-03
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty