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NPI Code Detail

MEDICARE: DOUG METZ DPM

MEDICARE:   DOUG  METZ  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
1174400000XSpecialistCA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1E2926OTHERCADOCTOR LICENSE NUMBER

General Provider Information

NPI Number : 1316129497
Entity Type Code : Individual
Provider Name (Legal Business Name) : DOUG METZ DPM
Provider Business Mailing Address
First Line : 1165 LINCOLN AVE
Second Line : SUITE 300
City : SAN JOSE
State : CA
Zip : 95125-3043
Country : US
Telephone Number : 408-287-3785
Fax Number : 408-287-2701
Provider Business Practice Location Address
First Line : 1165 LINCOLN AVE
Second Line : SUITE 300
City : SAN JOSE
State : CA
Zip : 95125-3043
Country : US
Telephone Number : 408-287-3785
Fax Number : 408-287-2701
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2007
Last Update Date : 11/30/2007

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Directions to “ DOUG METZ DPM” Practice Location

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