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PACIFIC FOOT & ANKLE CENTER - A PODIATRY CORPORATION NPI 1780623173


NPI Information

NPI: 1780623173
Provider Name: PACIFIC FOOT & ANKLE CENTER - A PODIATRY CORPORATION
Classification: Podiatrist - 213ES0103X
Entity Type: Organization

Specialization: Foot & Ankle Surgery

Address:
24191 PASEO DE VALENCIA
SUITE E
LAGUNA WOODS, CA
ZIP 92637
Phone: (949) 855-1177
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PACIFIC FOOT & ANKLE CENTER - A PODIATRY CORPORATION is a foot and ankle surgery podiatrist in Laguna Woods, CA. PACIFIC FOOT & ANKLE CENTER - A PODIATRY CORPORATION NPI is 1780623173. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

24191 PASEO DE VALENCIA
SUITE E
LAGUNA WOODS, CA
ZIP 92637-167
Phone: (949) 855-1177
Fax: (949) 855-6939

The provider's authorized official is David Petersen .
The authorized official title is Owner President and has the following contact phone number (949) 855-1177.

The enumeration date for this NPI number is 6/4/2006 and was last updated on 9/28/2010.


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
1213ES0103XPodiatristFoot & Ankle SurgeryE4310CALIFORNIAYes

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
1DE7237OTHERCALIFORNIARAILROAD MEDI-CARE PIN
2U86681MEDICARE UPINCALIFORNIA
3W19818MEDICARE PINCALIFORNIA
45973720001MEDICARE NSC

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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