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Dr. Jonathan Dietz, DO
Adult Medicine Physician in San Rafael, California
NPI 1366566499

Jonathan Dietz is an Adult Medicine Physician based in San Rafael, CA and is specialized in Adult Medicine. Jonathan Dietz practices in San Rafael, CA and has the professional credentials of DO. The NPI Number for Jonathan Dietz is 1366566499 and holds a License No. 20A7626 (California).

The current practice location address for Jonathan Dietz is 540 D St, San Rafael, CA and can be reached out via phone at 415-459-7416.

Location: 540 D St, San Rafael, CA, 94901-3867
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1366566499
Provider Name
Jonathan Dietz
Credential
DO
Provider Entity Type
Individual
Gender
Male
Address
540 D St, San Rafael, CA, 94901-3867
Phone Number
415-459-7416
Fax Number
Provider Enumeration Date
03/16/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
09171981 01 NM SON'S BIRTH
institution
Provider Business Practice Location Address Details
Address
540 D St
City
San Rafael
State
California
Zip
94901-3867
Phone Number
415-459-7416
Fax Number
person
Provider Business Mailing Address Details
Address
540 D St
City
San Rafael
State
California
Zip
94901-3867
Phone Number
415-459-7416
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Family Medicine
Speciality
Adult Medicine
Taxonomy
207QA0505X
License No.
20A7626 (California)
Definition
Definition to come.
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