MEDICARE: JAMES JOHN FELFOLDI D.P.M.

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	E1701	CA

General Provider Information

NPI Number	:	1740321520
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES JOHN FELFOLDI D.P.M.

Provider Business Mailing Address
First Line	:	3340 KEMPER ST STE 102
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92110-4907
Country	:	US
Telephone Number	:	619-225-9601
Fax Number	:	619-225-9606

Provider Business Practice Location Address
First Line	:	3340 KEMPER ST STE 102
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92110-4907
Country	:	US
Telephone Number	:	619-225-9601
Fax Number	:	619-225-9606

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

Provider Enumeration Date	:	02/12/2007
Last Update Date	:	11/05/2013

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