Provider Demographics
NPI:1124349667
Name:DE LA MORA, DIEGO (MD)
Entity type:Individual
Prefix:DR
First Name:DIEGO
Middle Name:
Last Name:DE LA MORA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:DIEGO
Other - Middle Name:
Other - Last Name:DELAMORA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 360557
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15251-6557
Mailing Address - Country:US
Mailing Address - Phone:915-215-5167
Mailing Address - Fax:915-215-8640
Practice Address - Street 1:8045 N LOOP DR STE A
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79915-3227
Practice Address - Country:US
Practice Address - Phone:915-215-5167
Practice Address - Fax:915-215-8640
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-18
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP6155207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine