=====================================================
General NPI Number Information
=====================================================
NPI Number | 1023423944
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | COLE MICHEAL HEMBRE DPM
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/30/2014
-----------------------------------------------------
Last Update Date | 11/05/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2216 BUENAVENTURA BLVD STE A
-----------------------------------------------------
City | REDDING
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 96001-3838
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 530-891-3338
-----------------------------------------------------
Fax | 530-221-2111
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1806 FOUNDATION LN
-----------------------------------------------------
City | CHICO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95928-9206
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 530-891-3338
-----------------------------------------------------
Fax | 530-894-5711
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 213ES0103X
-----------------------------------------------------
Taxonomy Name | Foot & Ankle Surgery Podiatrist
-----------------------------------------------------
License Number | E5866
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 213E00000X
-----------------------------------------------------
Taxonomy Name | Podiatrist
-----------------------------------------------------
License Number | E5866
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------