Provider Type Icon

HIGH DESERT FOOT & ANKLE CLINIC A PROFESSIONAL CORPORATION NPI 1104204775


NPI Information

NPI: 1104204775
Provider Name: HIGH DESERT FOOT & ANKLE CLINIC, A PROFESSIONAL CORPORATION
Classification: Podiatrist - 213ES0103X
Entity Type: Organization

Specialization: Foot & Ankle Surgery

Address:
15366 11TH ST
SUITE A
VICTORVILLE, CA
ZIP 92395
Phone: (760) 951-1234
Get Directions

HIGH DESERT FOOT & ANKLE CLINIC, A PROFESSIONAL CORPORATION is a foot and ankle surgery podiatrist in Victorville, CA. HIGH DESERT FOOT & ANKLE CLINIC, A PROFESSIONAL CORPORATION NPI is 1104204775. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

15366 11TH ST
SUITE A
VICTORVILLE, CA
ZIP 92395-726
Phone: (760) 951-1234
Fax: (760) 951-1611

The provider's authorized official is Wonsik Y Bollmann .
The authorized official title is Owner/podiatrist and has the following contact phone number (760) 951-1234.

The enumeration date for this NPI number is 5/14/2015 and was last updated on 5/14/2015.


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 SurgeryE3966CALIFORNIAYes

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: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.