Active NPI
Teodoro G Diaz III, DO
- Family Medicine Physician
- Ontario, CA
National Provider Identifier
1437190113
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 20A8127
- Practice address
- 3550 E Philadelphia St
Suite 150
Ontario, CA 91761-2962 - Phone
- (909) 773-0022
- Fax
- (909) 781-6013
- NPI assigned
- Jun 10, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 20A8127 | CA | Primary |
Addresses
Primary practice location
3550 E Philadelphia St
Suite 150
Ontario, CA 91761-2962
Mailing address
3550 E Philadelphia St
Suite 150
Ontario, CA 91761-2962
Phone (909) 773-0022
Other names 1
- Dr. Teodoro G Diaz III
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20A8127 | CA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wu & Diaz Professional Corp | Family Medicine | Past | Accepting new patients |
Interoperability endpoints
- ted.diaz.1@7542.direct.athenahealth.com
- zahra.akberzie.1@7542.direct.athenahealth.com
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Family Medicine Physician
- Ontario, CA
- NPI 1548356884
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149897600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1447200000000",
"number": "1437190113",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3550 E PHILADELPHIA ST",
"address_2": "SUITE 150",
"city": "ONTARIO",
"state": "CA",
"postal_code": "917612962",
"telephone_number": "909-773-0022",
"fax_number": "909-781-6013"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3550 E PHILADELPHIA ST",
"address_2": "SUITE 150",
"city": "ONTARIO",
"state": "CA",
"postal_code": "917612962",
"telephone_number": "909-773-0022",
"fax_number": "909-781-6013"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIAZ",
"first_name": "TEODORO",
"middle_name": "G",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-10",
"last_updated": "2015-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "20A8127",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "TEODORO",
"last_name": "DIAZ",
"middle_name": "G",
"prefix": "DR.",
"suffix": "III",
"credential": "DO",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Ontario, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.