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General NPI Number Information
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NPI Number | 1699043810
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Entity Type | Organization
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Legal Business Name | PODIATRY PLAN INC
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Dates
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Enumeration Date | 12/02/2011
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Last Update Date | 10/29/2020
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Provider Practice Location Address
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Address Line | 1353B HAIGHT STREET
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City | SAN FRANCISCO
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State | CA
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Zip | 94117
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Country | US
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Telephone | 800-367-7762
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Fax | 415-928-0228
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Provider Business Mailing Address
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Address Line | PO BOX 14817
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City | SAN FRANCISCO
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State | CA
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Zip | 94114-0817
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | SHAWN EVANS
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Credential |
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Telephone | 415-465-2534
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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 | E1396
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License Number State | CA
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