Marco Antonio Diaz, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

A67180 Issued in CA

Practice address

1300 W 7TH St
San Pedro, CA 90732-3505

Phone

(310) 514-5350

Fax

(310) 514-5421

NPI assigned

Jul 6, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Intercommunity Emergency Medical Group

  • Emergency Medicine Physician
  • Whittier, CA
  • NPI 1871535286
  Medicare reassignment NPD
• Grossmont Emergency Medical Group

  • Emergency Medicine Physician
  • La Mesa, CA
  • NPI 1861437501
  NPD (past)
• Stephen R. Shea, M.D., Inc.

  • Emergency Medicine Physician
  • Long Beach, CA
  • NPI 1326079872
  NPD (past)

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214352000000",
    "number": "1710919345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 661360",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910661360",
            "telephone_number": "626-447-0296",
            "fax_number": "626-447-6057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 W 7TH ST",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907323505",
            "telephone_number": "310-514-5350",
            "fax_number": "310-514-5421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "MARCO",
        "middle_name": "ANTONIO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2008-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A67180",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A671800",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alfred Alex Devin
• Jaskaran Dhingsa, M.D.
• Diagnostic Imaging and Dynamics, LLC
• Domenica Diaz Barrientos
• Christine Diaz
• Robin Linda Dieda, L.C.S.W.
• Ivy Adao Diosa
• Adam Dishkin
• Venu Divi, M.D.
• Lamont Edward Dobbins Jr.

• Emergency Medicine Physician in San Pedro, CA
• Providers in San Pedro, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.