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General NPI Number Information
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NPI Number | 1891112678
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Entity Type | Organization
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Legal Business Name | JASON BLYTHE, DPM, INC
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Dates
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Enumeration Date | 03/18/2014
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Last Update Date | 03/18/2014
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Provider Practice Location Address
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Address Line | 2480 MISSION ST STE 327
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City | SAN FRANCISCO
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State | CA
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Zip | 94110-2468
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Country | US
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Telephone | 415-577-0947
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Fax |
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Provider Business Mailing Address
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Address Line | 2480 MISSION ST STE 327
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City | SAN FRANCISCO
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State | CA
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Zip | 94110-2468
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Country | US
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Telephone | 415-577-0947
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JASON BLYTHE
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Credential | DPM
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Telephone | 415-577-0947
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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 | E4637
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License Number State | CA
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