Healthcare Provider Details

I. General information

NPI: 1649230749
Provider Name (Legal Business Name): FRANK J WITT DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2006
Last Update Date: 08/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1092 S MAIN AVE
FALLBROOK CA
92028-3324
US

IV. Provider business mailing address

1092 S MAIN AVE
FALLBROOK CA
92028-3324
US

V. Phone/Fax

Practice location:
  • Phone: 760-728-4800
  • Fax: 760-728-0061
Mailing address:
  • Phone: 760-728-4800
  • Fax: 760-728-0061

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberE3032
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: