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General NPI Number Information
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NPI Number | 1558833285
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Entity Type | Organization
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Legal Business Name | PACIFIC POINT PODIATRY, INC
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Dates
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Enumeration Date | 12/19/2018
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Last Update Date | 04/26/2023
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Provider Practice Location Address
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Address Line | 9500 SOQUEL DR STE A
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City | APTOS
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State | CA
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Zip | 95003-4158
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Country | US
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Telephone | 831-288-3400
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Fax | 831-288-3405
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Provider Business Mailing Address
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Address Line | 9500 SOQUEL DR STE A
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City | APTOS
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State | CA
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Zip | 95003-4158
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Country | US
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Telephone | 831-288-3400
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Fax | 831-288-3405
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Authorized Official
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Title or Position | CEO/OWNER
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Name | TEA NGUYEN
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Credential | DPM
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Telephone | 831-708-1110
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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 |
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License Number State |
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