Provider Demographics
NPI:1053354597
Name:DIAZ, RODNEY C (MD)
Entity type:Individual
Prefix:DR
First Name:RODNEY
Middle Name:C
Last Name:DIAZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2521 STOCKTON BLVD
Mailing Address - Street 2:SUITE 7200
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-2207
Mailing Address - Country:US
Mailing Address - Phone:916-734-3744
Mailing Address - Fax:916-703-5011
Practice Address - Street 1:2521 STOCKTON BLVD
Practice Address - Street 2:SUITE 7200
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-2207
Practice Address - Country:US
Practice Address - Phone:916-734-3744
Practice Address - Fax:916-703-5011
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA074869207Y00000X, 207YX0901X
MI4301083300207Y00000X, 207YX0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No207YX0901XAllopathic & Osteopathic PhysiciansOtolaryngologyOtology & Neurotology
Provider Identifiers
StateIdentifier IDID TypeIssuer
00A748690Medicare PIN