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DELTA PODIATRY GROUP INC. NPI 1023169471


NPI Information

NPI: 1023169471
Provider Name: DELTA PODIATRY GROUP, INC.
Classification: Podiatrist - 213E00000X
Entity Type: Organization
Address:
1205 N HUNTER ST
STOCKTON, CA
ZIP 95202
Phone: (209) 464-7367
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DELTA PODIATRY GROUP, INC. is a podiatrist in Stockton, CA. The provider is a podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. DELTA PODIATRY GROUP, INC. NPI is 1023169471. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1205 N HUNTER ST
STOCKTON, CA
ZIP 95202-409
Phone: (209) 464-7367
Fax: (209) 464-1801

The provider's authorized official is Lynn Robert Johnson .
The authorized official title is President and has the following contact phone number (209) 464-7367.

The enumeration date for this NPI number is 1/14/2007 and was last updated on 4/2/2009.


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
1213E00000XPodiatristE1406CALIFORNIAYes

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
1ZZZ25718ZMEDICARE ID-TYPE UNSPECIFIEDCALIFORNIA
2E1406OTHERCALIFORNIALICENSE NUMBER
30554330001MEDICARE NSCCALIFORNIA
4T10941MEDICARE UPINCALIFORNIA
5ZZZ73253ZMEDICAIDCALIFORNIA

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: 5/5/2024

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