Healthcare Provider Details

I. General information

NPI: 1023423944
Provider Name (Legal Business Name): COLE MICHEAL HEMBRE DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2014
Last Update Date: 11/05/2024
Certification Date: 11/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2216 BUENAVENTURA BLVD STE A
REDDING CA
96001-3838
US

IV. Provider business mailing address

1806 FOUNDATION LN
CHICO CA
95928-9206
US

V. Phone/Fax

Practice location:
  • Phone: 530-891-3338
  • Fax: 530-221-2111
Mailing address:
  • Phone: 530-891-3338
  • Fax: 530-894-5711

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberE5866
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberE5866
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: