ST JUDE HOSPITAL YORBA LINDA NPI 1831587955

NPI Information

ST JUDE HOSPITAL YORBA LINDA is a podiatrist in Petaluma, 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. ST JUDE HOSPITAL YORBA LINDA NPI is 1831587955. The provider is registered as an organization entity type.
The provider Is Doing Business As St Joseph Heritage Healthcare.

The provider's business location address is:

108 LYNCH CREEK WAY
SUITE 3
PETALUMA, CA
ZIP 94954-357
Phone: (707) 763-7403
Fax: (707) 789-0900

The provider's authorized official is Bob Just .
The authorized official title is Chief Operating Officer and has the following contact phone number (707) 303-8355.

The enumeration date for this NPI number is 12/23/2014 and was last updated on 7/14/2015.

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:

Other Identifiers

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