Provider Demographics
NPI:1861589616
Name:DIEKMANN-GUIROY, BERNADETTE (MD)
Entity type:Individual
Prefix:
First Name:BERNADETTE
Middle Name:
Last Name:DIEKMANN-GUIROY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:416B MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-3306
Mailing Address - Country:US
Mailing Address - Phone:831-800-7887
Mailing Address - Fax:831-998-7155
Practice Address - Street 1:236 SAN JOSE ST
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-3901
Practice Address - Country:US
Practice Address - Phone:831-422-2666
Practice Address - Fax:831-772-0892
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA53311208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH02445Medicare UPIN
CA00A533112Medicare PIN