Basic Information
Provider Information
NPI: 1073970034
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DIAMOND
FirstName: TERI
MiddleName: Z.
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2923 BRADLEY ST.
Address2: SUITE 120
City: PASADENA
State: CA
PostalCode: 911071503
CountryCode: US
TelephoneNumber: 6267956596
FaxNumber:  
Practice Location
Address1: 3330 LOMITA BLVD
Address2:  
City: TORRANCE
State: CA
PostalCode: 905055002
CountryCode: US
TelephoneNumber: 3103259110
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/21/2016
LastUpdateDate: 07/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000XA132054CAY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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