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Dr. Dirk Ross Diefendorf, MD
Sports Medicine (Neuromusculoskeletal Medicine) Physician in San Mateo, California
NPI 1467559443

Dirk Ross Diefendorf is a Sports Medicine (Neuromusculoskeletal Medicine) Physician based in San Mateo, CA. Dirk Ross Diefendorf practices in San Mateo, CA and has the professional credentials of MD. The NPI Number for Dirk Ross Diefendorf is 1467559443 and holds a License No. G53558 (California).

The current practice location address for Dirk Ross Diefendorf is 101 S Ellsworth Ave, San Mateo, CA and can be reached out via phone at 650-347-0157 and via fax at 650-347-0566.

Location: 101 S Ellsworth Ave, San Mateo, CA, 94401-3956
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1467559443
Provider Name
Dirk Ross Diefendorf
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
101 S Ellsworth Ave, San Mateo, CA, 94401-3956
Phone Number
650-347-0157
Fax Number
650-347-0566
Provider Enumeration Date
09/20/2006
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
101 S Ellsworth Ave
City
San Mateo
State
California
Zip
94401-3956
Phone Number
650-347-0157
Fax Number
650-347-0566
person
Provider Business Mailing Address Details
Address
101 S Ellsworth Ave
City
San Mateo
State
California
Zip
94401-3956
Phone Number
650-347-0157
Fax Number
650-347-0566
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Neuromusculoskeletal Medicine, Sports Medicine
Speciality
-
Taxonomy
204C00000X
License No.
G53558 (California)
Definition
Definition to come.
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