DISORDERS OF THE FOOT AND ANKLE A MEDICAL CORPORATION (NPI# 1184650921) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184650921 |
| Entity Type | Organization |
| Organization Name | DISORDERS OF THE FOOT AND ANKLE A MEDICAL CORPORATION |
| Practice Address |
4130 La Jolla Village Dr. Suite 300 La Jolla CA 92037-1481 |
| Practice Telephone | 8586257979 |
| Practice Fax Number | 8586252020 |
| Mailing Telephone | 8586257979 |
| Mailing Fax Number | 8586252020 |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2011-05-17 |
| Authorized Official Name | SHARON MARIE DREEBEN (OWNER) |
| Authorized Official Telephone | 8586257979 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XX0004X |
Orthopaedic Surgery Specialization: Foot and Ankle Surgery |
G67534 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00G675340 | 05 | |
| CA | RAILROAD MEDICARE PTAN | 200045199 | 01 |
| Street Address |
4130 LA JOLLA VILLAGE DR. SUITE 300 |
| City | LA JOLLA |
| State | CA |
| Zip Code | 92037-1481 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083842090 | La Jolla Optique | Ophthalmology | 4130 La Jolla Village Dr., Suite 102, La Jolla, CA 92037-1480 | 2009-06-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982221768 | Equip Health Medical, PC | Clinic/Center | 2674 Costebelle Drive, Unit A, La Jolla, CA 92037 | 2020-06-29 |
| 1134745474 | Brenda Kay Wiederhold | Psychologist | Virtual Reality Medical Center, 9834 Genesee Avenue, Suite 427, La Jolla, CA 92037 | 2020-06-23 |
| 1316581598 | Kathleen M Blechertas | Physical Therapist | 9888 Genesee, Lj19, La Jolla, CA 92037 | 2019-10-31 |
| 1316592876 | Kevin Yanyan Li | Student in an Organized Health Care Education/Training Program | 9300 Campus Point Drive, Mc7400, La Jolla, CA 92037 | 2019-08-01 |
| 1407400542 | Juan J Salmeron | Dentist | Callejin Internacional 351 L2, Los Algodones, BAJA CALIFORNIA 92037 | 2019-07-26 |
| 1609428598 | Nicole Whitney Mark | Physician Assistant | 8103 Caminito Sonoma, La Jolla, CA 92037 | 2019-07-11 |
| 1700357936 | Cecelia Rose Greene/pendzich | Mastectomy Fitter | 7760 Fay Ave, Suite M., La Jolla, CA 92037 | 2018-12-16 |
| 1740765890 | Jeenal Ankit Gordhandas | Student in an Organized Health Care Education/Training Program | East Campus Office Building, Medical Center Dr, La Jolla, CA 92037 | 2018-09-25 |
| 1306325220 | Lisa Beth Perlov Marks | Marriage & Family Therapist | 7734 Hershel Avenue, Suite O, La Jolla, CA 92037 | 2018-08-10 |
| 1023596731 | Uc San Diego, Pathology Dept | Pathology | East Campus Office Building, Medical Center Dr, San Diego, CA 92037 | 2018-08-03 |
| Find all providers in zip 92037 | ||||
| Taxonomy Code | 207XX0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Foot and Ankle Surgery |
| Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, foot and ankle surgeons deal with adult reconstructive foot and ankle surgery, adult foot and ankle trauma, sports medicine foot and ankle, and children's foot and ankle reconstructive surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: title modified, definiton added, source added] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Separate board certification is not currently offered. ACGME Accredited Residency Program Requirements: 1 year of training with 5 years Orthopedic Surgery for a total of 6 years. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215562236 | Walk Run Randall | Orthopaedic Surgery | 28829 Pujol St Apt 718, Temecula, CA 92590-6710 | 2020-03-10 |
| 1003469370 | Total Care Podiatry Services, Inc. | Orthopaedic Surgery | 1663 Eucalyptus Ct, Los Banos, CA 93635-6201 | 2019-07-16 |
| 1508333758 | Lc Loggins | Orthopaedic Surgery | 4041 Altamont Ave, Oakland, CA 94605-2603 | 2018-10-25 |
| 1487996864 | Edward Leo Garr | Orthopaedic Surgery | 1811 Sirrine Dr, Santa Ana, CA 92705-1594 | 2013-03-22 |
| 1124368667 | Candice Lillian Brady | Orthopaedic Surgery | 400 Camarillo Ranch Rd Ste 101, Camarillo, CA 93012-5901 | 2013-02-20 |
| 1477855955 | Desert Orthopedic Center A Medical Group Inc | Orthopaedic Surgery | 45280 Seeley Dr Fl 2 Rm 3lq, La Quinta, CA 92253-6834 | 2010-12-03 |
| 1184710642 | Clifford D Merkel | Orthopaedic Surgery | 1901 West Lugonia Avenue, Suite 120, Redlandss, CA 92374 | 2006-10-04 |
| 1265462337 | Osep Armagan | Orthopaedic Surgery | 141 Triunfo Canyon Rd, Suite 101, Westlake Village, CA 91361-2525 | 2006-07-04 |
| 1417925462 | Kenneth S. Jung II | Orthopaedic Surgery | 6801 Park Terrace Drive, Los Angeles, CA 90045 | 2006-03-08 |
| 1801899398 | Ronald W Smith | Orthopaedic Surgery | 2840 Long Beach Blvd, #440, Long Beach, CA 90806-1590 | 2005-05-27 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.