Pacific Coast Podiatry Pc

LBN: Pacific Coast Podiatry Pc
Pacific Coast Podiatry Pc is an health care organization with primary practice located at 1762 N Waterman Ave , San Bernardino CA 92404-5130. The organization recently has only one registered license in Managed Care Organizations / Preferred Provider Organization, which is considered as the primary health care specialty. Pacific Coast Podiatry Pc can be contacted via phone (909) 886-3668, or through Johnsen, Clayton Gary via phone (909) 886-3668.

Contact Information

Primary practice address
1762 N Waterman Ave San Bernardino CA 92404-5130
Phone: (909) 886-3668
Fax: (909) 886-5542
Website:
Map and Directions
Authorized official contact:
Name: Johnsen, Clayton Gary Doctor of Podiatric Medicine (DPM)
Phone: (909) 886-3668

Health care specialties

SpecialtyCodeLicense #State
Managed Care Organizations / Preferred Provider Organization 305R00000X E4834 California

Profile Details

NPI number 1285080978
LBN Legal business name Pacific Coast Podiatry Pc
DBA Doing business as
Authorized official Johnsen, Clayton Gary Doctor of Podiatric Medicine (DPM)
Entity Organization
Organization subpart 1 No
Enumeration date May 11th, 2016
Last updated Jun 20th, 2022 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285080978 NPPES
Other 1285080978 NPI

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