MEDICARE: DR. SUSAN HEIDI KIRKPATRICK DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	E3748	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	0935724	OTHER		MEDICAL PIN #

General Provider Information

NPI Number	:	1285646034
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUSAN HEIDI KIRKPATRICK DPM

Provider Business Mailing Address
First Line	:	PO BOX 1695
Second Line	:
City	:	ARCADIA
State	:	CA
Zip	:	91077-1695
Country	:	US
Telephone Number	:	626-574-7592
Fax Number	:	626-447-3704

Provider Business Practice Location Address
First Line	:	20 E HUNTINGTON DR
Second Line	:
City	:	ARCADIA
State	:	CA
Zip	:	91006-3209
Country	:	US
Telephone Number	:	626-574-7592
Fax Number	:	626-447-3704

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/12/2006
Last Update Date	:	07/08/2007

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