Provider Demographics
NPI:1598525909
Name:PATRICK W DIESFELD MD A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:PATRICK W DIESFELD MD A PROFESSIONAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:DIESFELD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-648-2717
Mailing Address - Street 1:168 N BRENT ST STE 407
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-2824
Mailing Address - Country:US
Mailing Address - Phone:805-648-7127
Mailing Address - Fax:805-648-2023
Practice Address - Street 1:168 N BRENT ST STE 407
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-2824
Practice Address - Country:US
Practice Address - Phone:805-648-2717
Practice Address - Fax:805-648-2023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-21
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty