Diakoniamed

NPI #1699265868 in Fullerton, California

Provider Information

NPI Number: 1699265868
Entity Type: Organization
Organization Name: Diakoniamed
Primary Specialty: Dermatology
Enumeration Date: May 14, 2018
Last Updated: Jul 16, 2019

Practice Location

Address: 2720 N HARBOR BLVD STE 205
City: Fullerton
State: California
ZIP Code: 92835-2609
Phone: (718) 882-5525

Authorized Official

Name: DR. DAVID SIRE, MD
Title: MEDICAL DIRECTOR
Phone: (714) 882-5525

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dermatology	207N00000X	Primary

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