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1083430854
FREDY JESUS DIAZ
BIG BEAR LAKE, CA
NPI
1083430854
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
172V00000X Community Health Worker
Enumeration Date
2024-11-26
Last Update Date
2024-11-26
Business Address
FREDY JESUS DIAZ
PO BOX 6609
BIG BEAR LAKE, CA 92315-6609
Phone number: 909-878-2326
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Mailing Address
FREDY JESUS DIAZ
1019 SIERRA AVE
BIG BEAR CITY, CA 92314-9779
Phone number: 909-521-5709
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