Healthcare Provider Details

I. General information

NPI: 1861139362
Provider Name (Legal Business Name): KEVIN ALAN COX, DPM, PODIATRY CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2022
Last Update Date: 09/04/2024
Certification Date: 09/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8851 CENTER DR # 406
LA MESA CA
91942-3017
US

IV. Provider business mailing address

8851 CENTER DR # 406
LA MESA CA
91942-3017
US

V. Phone/Fax

Practice location:
  • Phone: 619-465-3200
  • Fax: 619-465-3700
Mailing address:
  • Phone: 619-465-3200
  • Fax: 619-465-3700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: KEVIN ALAN COX
Title or Position: OWNER, SOLE DIRECTOR
Credential: DPM
Phone: 928-451-5752