Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Carmelo O Diaz, PA-C

Individual provider Physician Assistant · NPI 1326420217

Mr. Carmelo O Diaz, PA-C is a Physician Assistant in Salt Lake City, Utah. Qualified in 2015, 11 years ago. Practices with La Laser Center PC a Professional Medical Corporation, a 80-clinician group and accepts Medicare assignment. Licensed in California and Utah.

Years since qualifying
11
Licensed in
CA, UT
In the registry since
2015
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

660 S 200 E Ste 250
Salt Lake City, UT 84111-3835
Phone: (801) 359-2256
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 9453799-1206 (UT)
Physician Assistant Taxonomy 363A00000X · Licence PA57869 (CA)

Record details

NPI number1326420217
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJune 26, 2015
Last updated in NPPESSeptember 23, 2021
Certification dateSeptember 23, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice La Laser Center Pc A Professional Medical Corporation — 80 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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