National Provider Identifier Database

PACIFIC COAST PODIATRY PC
Preferred Provider Organization

A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level.


Contact Information

PACIFIC COAST PODIATRY PC
1762 N WATERMAN AVE
SAN BERNARDINO, CA92404-5130
Phone: 909-886-3668
Fax: 909-886-5542
Website:
Specialty Taxonomy Code
* Preferred Provider Organization 305R00000X

* Indicates primary specialty

NPI Profile & details for PACIFIC COAST PODIATRY PC

NPI Number 1285080978
Legal business name
LBN
PACIFIC COAST PODIATRY PC
Authorized official CLAYTON JOHNSEN - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 05/11/2016
Last updated 06/20/2022 - About 4 years ago
Sole proprietor1 Not specified
Identifiers
  • CA License #: E4834
  • Other: 1285080978 NPI

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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