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SAN BERNARDINO FOOT AND WOUND NPI 1821710559


NPI Information

NPI: 1821710559
Provider Name: SAN BERNARDINO FOOT AND WOUND

Former Legal Business Name: SAN BERNARDO FOOT AND WOUND

Classification: Podiatrist - 213ES0131X
Entity Type: Organization

Specialization: Foot Surgery

CLIA Number: 05D2087594

Address:
7426 CHERRY AVE STE 210-123
FONTANA, CA
ZIP 92336
Phone: (909) 601-7193
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SAN BERNARDINO FOOT AND WOUND is a foot surgery podiatrist in Fontana, CA. SAN BERNARDINO FOOT AND WOUND NPI is 1821710559. The provider is registered as an organization entity type and is a single specialty group.
The provider Former Legal Business Name Is San Bernardo Foot And Wound.

The provider's business location address is:

7426 CHERRY AVE STE 210-123
FONTANA, CA
ZIP 92336-221
Phone: (909) 601-7193

The provider's authorized official is Norris Donald Morrison .
The authorized official title is Dpm and has the following contact phone number (951) 479-2915.

The CLIA number assigned to this NPI record is 05D2087594 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/19/2022 and was last updated on 10/4/2022.


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
1213ES0131XPodiatristFoot SurgeryYes

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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