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General NPI Number Information
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NPI Number | 1528190832
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Entity Type | Organization
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Legal Business Name | DIABETIC FOOT & WOUND TREATMENT CENTERS
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Dates
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Enumeration Date | 03/12/2007
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Last Update Date | 09/19/2012
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Provider Practice Location Address
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Address Line | 1553B GRAND AVE
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City | SAN MARCOS
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State | CA
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Zip | 92078-2427
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Country | US
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Telephone | 760-744-6226
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Fax | 760-744-6277
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Provider Business Mailing Address
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Address Line | 1553B GRAND AVE
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City | SAN MARCOS
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State | CA
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Zip | 92078-2427
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Country | US
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Telephone | 760-744-6226
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Fax | 760-744-6277
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Authorized Official
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Title or Position | CEO
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Name | DR. KENNETH B REHM
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Credential | DPM
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Telephone | 760-744-6226
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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 | E2808
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License Number State | CA
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