J. Manuel Gonzalez-Diaz M.D.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

LAB62080F Issued in CA

Legal business name

J. MANUEL GONZALEZ-DIAZ M.D.

Practice address

13500 Van Nuys Blvd
Pacoima, CA 91331-3028

Phone

(818) 896-2999

Fax

(818) 896-8449

NPI assigned

Oct 9, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Christine Grace Halverson

Title

Insurance Billing

Phone

(818) 994-6177

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jose Manuel Gonzalez-Diaz, MD

  • General Practice Physician
  • Pacoima, CA
  • NPI 1205927415
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1191888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191888000000",
    "number": "1083802573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13500 VAN NUYS BLVD",
            "city": "PACOIMA",
            "state": "CA",
            "postal_code": "913313028",
            "telephone_number": "818-896-2999",
            "fax_number": "818-896-8449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13500 VAN NUYS BLVD",
            "city": "PACOIMA",
            "state": "CA",
            "postal_code": "913313028",
            "telephone_number": "818-896-2999",
            "fax_number": "818-896-8449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J. MANUEL GONZALEZ-DIAZ M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-09",
        "last_updated": "2007-10-09",
        "status": "A",
        "authorized_official_last_name": "HALVERSON",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_middle_name": "GRACE",
        "authorized_official_title_or_position": "INSURANCE BILLING",
        "authorized_official_telephone_number": "818-994-6177",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "LAB62080F",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0086101",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle Iniguez
• Myra Kathleen Irani, M.A.
• Sara Nasser Issa, LMFT
• Taryn Danielle Iwamoto
• J & M Laurel Medical Center Inc
• J. V. Therapy Services Inc.
• Arianna Jacinto
• Kavindra M Jacobs
• Shuka Jahromifar
• Tesen T Jamison

• Clinical Medical Laboratory in Pacoima, CA
• Providers in Pacoima, CA by specialty
• Clinical Medical Laboratory in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.