DR. JONATHAN DIETZ D.O. NPI 1366566499

NPI Information

NPI: 1366566499
Provider Name: DR. JONATHAN DIETZ, D.O.
Classification: Family Medicine - 207QA0505X
Specialization: Adult Medicine
Entity Type: Individual
Address: 540 D ST
2
SAN RAFAEL, CA
ZIP 94901
Phone: (415) 459-7416

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NPI Details

DR. Jonathan Dietz, D.O. is an adult medicine family medicine in San Rafael, CA. The provider is the National Uniform Claim Committee (NUCC) recommends code 207QA0505X not be used. Choose a more appropriate code. DR. Jonathan Dietz, D.O. NPI is 1366566499. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

540 D ST
2
SAN RAFAEL, CA
ZIP 94901-867
Phone: (415) 459-7416

The enumeration date for this NPI number is 3/16/2007 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207QA0505X	Family Medicine	Adult Medicine	20A7626	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	09171981	OTHER	NEW MEXICO	SON'S BIRTH

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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