Provider Demographics
NPI:1174719850
Name:DIEHN, MAXIMILIAN (MD/PHD)
Entity type:Individual
Prefix:DR
First Name:MAXIMILIAN
Middle Name:
Last Name:DIEHN
Suffix:
Gender:M
Credentials:MD/PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:875 BLAKE WILBUR DR.
Mailing Address - Street 2:DEPT. OF RADIATION ONCOLOGY (MC-5847)
Mailing Address - City:STANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:94305-5847
Mailing Address - Country:US
Mailing Address - Phone:650-723-6171
Mailing Address - Fax:
Practice Address - Street 1:875 BLAKE WILBUR DR.
Practice Address - Street 2:DEPT. OF RADIATION ONCOLOGY (MC-5847)
Practice Address - City:STANFORD
Practice Address - State:CA
Practice Address - Zip Code:94305-5847
Practice Address - Country:US
Practice Address - Phone:650-723-6171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-17
Last Update Date:2007-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA921532085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology