Provider Demographics
NPI:1811158900
Name:MUNOZ, DIANA MARIE (DO, MA, MPH)
Entity type:Individual
Prefix:DR
First Name:DIANA
Middle Name:MARIE
Last Name:MUNOZ
Suffix:
Gender:F
Credentials:DO, MA, MPH
Other - Prefix:DR
Other - First Name:DIANA
Other - Middle Name:MARIE
Other - Last Name:MUNOZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO, MA, MPH
Mailing Address - Street 1:1805 E. DYER ROAD
Mailing Address - Street 2:#110
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-5742
Mailing Address - Country:US
Mailing Address - Phone:949-955-0022
Mailing Address - Fax:949-743-0567
Practice Address - Street 1:1805 E. DYER ROAD
Practice Address - Street 2:#110
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-5742
Practice Address - Country:US
Practice Address - Phone:949-955-0022
Practice Address - Fax:949-743-0567
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-20
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A10370208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation