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COASTAL PODIATRY CLINIC NPI 1336319698


NPI Information

NPI: 1336319698
Provider Name: COASTAL PODIATRY CLINIC

Doing Business As: COASTAL PODIATRY CLINIC

Classification: Podiatrist - 213ES0131X
Entity Type: Organization

Specialization: Foot Surgery

Address:
2 JAMES WAY
SUITE 205
PISMO BEACH, CA
ZIP 93449
Phone: (805) 773-3668
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COASTAL PODIATRY CLINIC is a foot surgery podiatrist in Pismo Beach, CA. COASTAL PODIATRY CLINIC NPI is 1336319698. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Coastal Podiatry Clinic.

The provider's business location address is:

2 JAMES WAY
SUITE 205
PISMO BEACH, CA
ZIP 93449-973
Phone: (805) 773-3668
Fax: (805) 773-1043

The provider's authorized official is Richard Jay Norman .
The authorized official title is Sole Proprietor and has the following contact phone number (805) 773-3668.

The enumeration date for this NPI number is 3/3/2008 and was last updated on 6/21/2019.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1213ES0131XPodiatristFoot SurgeryE4306CALIFORNIAYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1E4306OTHERCALIFORNIABOARD OF PODIATRIC MEDICINE LICENSE

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: 4/28/2024

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