| San Bernardino Foot Clinic, Inc. | |
|
2095 N Waterman Ave, San Bernardino, CA 92404-4834 | |
| (909) 882-3800 | |
| (909) 882-3380 |
| Full Name | San Bernardino Foot Clinic, Inc. |
|---|---|
| Type | Facility |
| Speciality | Podiatrist - Foot & Ankle Surgery |
| Location | 2095 N Waterman Ave, San Bernardino, California |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154352037 | NPI | - | NPPES |
| 000E44161 | Medicaid | CA | |
| CI863B | Other | CA | MEDICARE PTAN |
| DD297Z | Other | CA | MEDICARE INDIVIDUAL |
| 0253335 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 213ES0103X | Podiatrist - Foot & Ankle Surgery | E4416 (California) | Primary |
| Provider Name | Sang D Lee |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1780694356 PECOS PAC ID: 7719888254 Enrollment ID: I20040116000731 |
| Mailing Address | Practice Location Address |
|---|---|
| San Bernardino Foot Clinic, Inc. 2095 N Waterman Ave, San Bernardino, CA 92404-4834 Ph: (909) 882-3800 | San Bernardino Foot Clinic, Inc. 2095 N Waterman Ave, San Bernardino, CA 92404-4834 Ph: (909) 882-3800 |
Dr. Clayton Gary Johnsen, D.P.M. Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 1762 N Waterman Ave, San Bernardino, CA 92404 Phone: 909-886-3668 Fax: 909-886-5542 | |
Dr. Lucius Jr Hill Jr., DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 1738 N Waterman Ave, Ste 5, San Bernardino, CA 92404 Phone: 909-886-7700 Fax: 909-886-7707 | |
Stepwell Podiatry Group Inc Podiatrist Medicare: Medicare Enrolled Practice Location: 473 E Carnegie Drive, Suite 200, San Bernardino, CA 92408 Phone: 909-244-7430 Fax: 909-495-1380 | |
Providence Podiatry Care, Inc Podiatrist Medicare: Medicare Enrolled Practice Location: 473 E Carnegie Drive, Suite 200, San Bernardino, CA 92408 Phone: 909-244-7430 Fax: 909-495-1380 | |
Dr. Kevin Dean O'reilly, D.P.M. Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 1556 N D St, San Bernardino, CA 92405 Phone: 909-885-0652 Fax: 909-885-5022 | |
Dr. Sang Dae Lee, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 2095 N Waterman Ave, San Bernardino, CA 92404 Phone: 909-882-3800 Fax: 909-882-3380 |