Diamond Orthotic Laboratory

Primary specialty

Dental LaboratoryTaxonomy code 292200000X

Legal business name

DIAMOND ORTHOTIC LABORATORY

Practice address

7859 El Cajon Blvd
La Mesa, CA 91942-0602

Phone

(619) 724-6400

Fax

(619) 724-6401

NPI assigned

Apr 21, 2023

Organization subpart

No

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

Authorized official

Name

Matt Rago

Title

Coo

Phone

(619) 724-6400

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1682035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682035200000",
    "number": "1407543176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7859 EL CAJON BLVD",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919420602",
            "telephone_number": "619-724-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7859 EL CAJON BLVD",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919420602",
            "telephone_number": "619-724-6400",
            "fax_number": "619-724-6401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIAMOND ORTHOTIC LABORATORY",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-21",
        "last_updated": "2023-04-21",
        "certification_date": "2023-04-21",
        "status": "A",
        "authorized_official_last_name": "RAGO",
        "authorized_official_first_name": "MATT",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "619-724-6400"
    },
    "taxonomies": [
        {
            "code": "292200000X",
            "taxonomy_group": "",
            "desc": "Dental Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Desiree Brittain
• Kelly Dewitt, MD
• Sukhman Dhaliwal, DO
• Jasveen Dhillon, MS, PA-C
• Diabetes and Endocrine Associates
• Diamond Surgical Suites LLC
• Ashley Raquel Diaz I
• Hector Diaz Jr., IDC
• Jose Cruz Diaz Jr.
• Michelle Diaz, NP-C

• Dental Laboratory in La Mesa, CA
• Providers in La Mesa, CA by specialty
• Dental Laboratory in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2023; 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.