Individual provider · Type 1 NPI
Jonathan Dietz, DO
Adult Medicine Physician · San Rafael, CA
NPI number
1366566499
Active
Practice location
540 D St, 2
San Rafael, CA 94901-3867
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Adult Medicine Physician Primary | 207QA0505X | 20A7626 (CA) |
Adult Medicine Physician: The NUCC recommends this code not be used. Choose a more appropriate code.
About NPI 1366566499
Jonathan Dietz, DO's National Provider Identifier is 1366566499, issued on Mar 16, 2007. The primary taxonomy on file is Adult Medicine Physician (207QA0505X), and the practice location is in San Rafael, CA. The record was last updated on Jul 8, 2007.