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1578917936
JOSE LUIS DIEGO
MAYWOOD, IL
NPI
1578917936
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
208600000X Surgery
(Licence: IL 036161333)
Enumeration Date
2016-04-21
Last Update Date
2022-08-10
Business Address
JOSE LUIS DIEGO M.D.
2160 S 1ST AVE
MAYWOOD, IL 60153-3328
Phone number: 708-216-9000
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Mailing Address
JOSE LUIS DIEGO M.D.
3509 GLENCREST DR
MODESTO, CA 95355-8427
Phone number: 209-581-3052
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