Provider Demographics
NPI:1952570582
Name:TECH DIAMOND HEALTH CARE
Entity Type:Organization
Organization Name:TECH DIAMOND HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:AUDREY
Authorized Official - Middle Name:M
Authorized Official - Last Name:MIDDLETON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-857-6438
Mailing Address - Street 1:3201 SOUTHRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:CA
Mailing Address - Zip Code:94806-5244
Mailing Address - Country:US
Mailing Address - Phone:510-857-6438
Mailing Address - Fax:510-223-3120
Practice Address - Street 1:2098 BABCOCK LANE
Practice Address - Street 2:
Practice Address - City:TRACY
Practice Address - State:CA
Practice Address - Zip Code:95377
Practice Address - Country:US
Practice Address - Phone:510-857-6438
Practice Address - Fax:510-223-3120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-28
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health