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General NPI Number Information
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NPI Number | 1295899888
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Entity Type | Organization
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Legal Business Name | PODIATRY ASSOCIATES OF SAN DIEGO
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Dates
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Enumeration Date | 12/20/2006
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Last Update Date | 02/03/2015
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Provider Practice Location Address
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Address Line | 3330 THIRD AVENUE #402
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City | SAN DIEGO
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State | CA
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Zip | 92103-5639
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Country | US
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Telephone | 619-298-1733
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Fax | 619-294-9604
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Provider Business Mailing Address
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Address Line | 3330 THIRD AVENUE #402
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City | SAN DIEGO
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State | CA
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Zip | 92103-5639
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Country | US
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Telephone | 619-298-1733
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Fax | 619-294-9604
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | MARTIN R TAUBMAN
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Credential | D.P.M.
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Telephone | 619-298-1733
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | E2237
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License Number State | CA
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