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RICHARD M AND DONALD R GREEN PTRS DBA SAN DIEGO PODIATRY GROUP NPI 1962456400


NPI Information

NPI: 1962456400
Provider Name: RICHARD M AND DONALD R GREEN PTRS DBA SAN DIEGO PODIATRY GROUP

Doing Business As: SAN DIEGO PODIATRY GROUP

Classification: Podiatrist - 213ES0103X
Entity Type: Organization

Specialization: Foot & Ankle Surgery

Address:
2650 CAMINO DEL RIO N
SUITE 101
SAN DIEGO, CA
ZIP 92108
Phone: (619) 291-0777
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RICHARD M AND DONALD R GREEN PTRS DBA SAN DIEGO PODIATRY GROUP is a foot and ankle surgery podiatrist in San Diego, CA. RICHARD M AND DONALD R GREEN PTRS DBA SAN DIEGO PODIATRY GROUP NPI is 1962456400. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As San Diego Podiatry Group.

The provider's business location address is:

2650 CAMINO DEL RIO N
SUITE 101
SAN DIEGO, CA
ZIP 92108-621
Phone: (619) 291-0777
Fax: (619) 291-3231

The provider's authorized official is Benjamin Cullen .
The authorized official title is Podiatrist and has the following contact phone number (619) 291-0777.

The enumeration date for this NPI number is 5/20/2006 and was last updated on 4/7/2017.


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 SurgeryYes

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
1GRE000300MEDICAIDCALIFORNIA
20936240001MEDICARE NSCCALIFORNIA
3ZZZ40809ZOTHERCALIFORNIABLUE SHIELD

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

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