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General NPI Number Information
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NPI Number | 1972711273
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Entity Type | Organization
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Legal Business Name | JENS F BIRKHOLM D P M INC
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Dates
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Enumeration Date | 05/18/2007
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Last Update Date | 08/04/2010
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Provider Practice Location Address
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Address Line | 821 E CHAPEL ST STE 101
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City | SANTA MARIA
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State | CA
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Zip | 93454-4618
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Country | US
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Telephone | 805-925-8703
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Fax | 805-349-8315
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Provider Business Mailing Address
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Address Line | 821 E CHAPEL ST STE 101
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City | SANTA MARIA
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State | CA
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Zip | 93454-4618
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Country | US
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Telephone | 805-925-8703
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Fax | 805-349-8315
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Authorized Official
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Title or Position | OWNER
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Name | DR. JENS F,J. BIRKHOLM
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Credential | D.P.M.
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Telephone | 805-925-8703
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | E1444
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License Number State | CA
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