| |
500 South 7th Avenue, Suite A, Barstow, CA 92311-3056 | |
(760) 948-7400 | |
(760) 948-7866 |
Full Name | |
---|---|
Type | Facility |
Speciality | Podiatrist |
Location | 500 South 7th Avenue, Suite A, Barstow, California |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1710349055 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
213E00000X | Podiatrist | E3433 (California) | Primary |
Mailing Address | Practice Location Address |
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18151 Bear Valley Rd, Hesperia, CA 92345-4907 Ph: (760) 948-7400 | 500 South 7th Avenue, Suite A, Barstow, CA 92311-3056 Ph: (760) 948-7400 |