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General NPI Number Information
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NPI Number | 1467574616
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Entity Type | Individual
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Provider Name | JOSEPH T. BREEN D.P.M
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Gender | Male
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Dates
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Enumeration Date | 04/06/2007
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Last Update Date | 06/03/2019
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Provider Practice Location Address
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Address Line | 3798 JANES RD STE 9
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City | ARCATA
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State | CA
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Zip | 95521-4745
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Country | US
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Telephone | 707-599-8677
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Fax | 707-559-8176
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Provider Business Mailing Address
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Address Line | 3798 JANES RD STE 9
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City | ARCATA
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State | CA
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Zip | 95521-4745
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Country | US
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Telephone | 707-599-8677
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Fax | 707-559-8176
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 621
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | E4481
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License Number State | CA
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