BLAIR MOYLE JOLLEY (NPI# 1366737728) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366737728 |
| Entity Type | Individual |
| Full Name | BLAIR MOYLE JOLLEY |
| Credential | DPM |
| Practice Address |
13652 Cantara St Panorama City CA 91402-5423 |
| Practice Telephone | 8183752000 |
| Practice Fax Number | 8183753201 |
| Mailing Telephone | 8183752000 |
| Mailing Fax Number | 8183753201 |
| Enumeration Date | 2011-06-14 |
| Last Update Date | 2016-02-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
E5135 | CA | Podiatric Medicine & Surgery Service Providers |
| Street Address |
13652 CANTARA ST |
| City | PANORAMA CITY |
| State | CA |
| Zip Code | 91402-5423 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578560496 | Daniel Tri Vu | Optometrist | 13652 Cantara St, Panorama City, CA 91402-5423 | 2005-07-07 |
| 1982201406 | Nabbin Sonny Chammachel | Physical Therapist | 13652 Cantara St, Panorama City, CA 91402-5423 | 2020-10-07 |
| 1467090092 | Yoo Kyung Hong | Pharmacist | 13652 Cantara St, Panorama City, CA 91402-5423 | 2019-12-13 |
| 1518513860 | Jane Therese Morejon | Social Worker | 13652 Cantara St, Panorama City, CA 91402-5423 | 2019-08-13 |
| 1023575206 | Kristina Steinbruner | Occupational Therapist | 13652 Cantara St, Panorama City, CA 91402-5423 | 2019-02-25 |
| 1437626272 | Michelle Harden | Respiratory Therapist, Registered | 13652 Cantara St, Panorama City, CA 91402-5423 | 2018-10-30 |
| 1548736861 | Vahe Ghazarian | Respiratory Therapist, Registered | 13652 Cantara St, Panorama City, CA 91402-5423 | 2018-10-15 |
| 1366917197 | Julie Yoo | Pharmacist | 13652 Cantara St, Panorama City, CA 91402-5423 | 2018-10-08 |
| 1801361639 | Flavius Lucian Baiesc | Pharmacist | 13652 Cantara St, Panorama City, CA 91402-5423 | 2018-10-08 |
| 1447725361 | Vikram Sehdev | Respiratory Therapist, Registered | 13652 Cantara St, Panorama City, CA 91402-5423 | 2018-10-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457900979 | Natalie Levine | Physician Assistant | 9140 Van Nuys Blvd Ste 207, Panorama City, CA 91402 | 2019-09-06 |
| 1609423912 | Jannet De La Torre | Student in an Organized Health Care Education/Training Program | 8018 Broadleaf Ave., Panorama City, CA 91402 | 2019-08-21 |
| 1659838258 | Carlota Andon | Psychologist | 14907 Willard St., Panorama City, CA 91402 | 2019-03-01 |
| 1477037471 | Lisa Diaz | Respiratory Therapist, Registered | 13651 Cantara St, Panorama City, CA 91402 | 2018-09-17 |
| 1124500665 | Luis Valentine Ascencio Jr. | Respiratory Therapist, Certified | Southern Calif. Kaiser Permanente Hospital, 8110 Woodman Ave Building 5, Panorama City, CA 91402 | 2018-08-31 |
| 1669951562 | Floyd Bailey | Respiratory Therapist, Registered | 8110 Woodman Ave Bldg 5, Panorama City, CA 91402 | 2018-08-10 |
| 1265910285 | St. Rita's Congregate, Inc. | Nursing Facility/Intermediate Care Facility | 7818 Allott Ave, Van Nuys, CA 91402 | 2018-08-01 |
| 1255834370 | Bishoy Saad | Student in an Organized Health Care Education/Training Program | 8435 Minuet Pl, Panorama City, CA 91402 | 2018-03-15 |
| 1376080309 | International Pre-diabetes Center Inc | Registered Nurse | 14500 Roscoe Blvd., 4th Floor, 4th Floor, Panorama City, CA 91402 | 2017-01-29 |
| 1023489176 | Jane Ryang | Pharmacist | 13652 Cantara Street, Mo4 Room 105, Panorama City, CA 91402 | 2015-10-15 |
| Find all providers in zip 91402 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346500691 | Michelle Finkeltub Attar | Podiatrist | 13652 Cantara St, Panorama City, CA 91402-5423 | 2012-05-21 |
| 1871850552 | Robert James Stillwell IIi | Podiatrist | 13652 Cantara St, Panorama City, CA 91402-5423 | 2012-04-18 |
| 1285952473 | Marcie Louise Carter | Podiatrist | 13652 Cantara St, Panorama City, CA 91402-5423 | 2010-05-12 |
| 1295883189 | Bill Harries | Podiatrist | 13652 Cantara St, Panorama City, CA 91402-5423 | 2007-01-08 |
| 1417005323 | Kurtis H Chin | Podiatrist | 13652 Cantara St, Panorama City, CA 91402-5423 | 2007-01-08 |
| 1962561670 | Pamela D Leavitt | Podiatrist | 13652 Cantara St, Panorama City, CA 91402-5423 | 2006-12-08 |
| 1871652594 | Sharon J Bangalan | Podiatrist | 13652 Cantara St, Panorama City, CA 91402-5423 | 2006-12-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114528726 | Millennium Foot and Ankle Institute PC | Podiatrist | 26235 Ravenhill Rd, Santa Clarita, CA 91387-4046 | 2020-11-02 |
| 1861008054 | Ronald J Belczyk, Dpm Inc. | Podiatrist | 5471 La Palma Ave Ste 106, La Palma, CA 90623-1792 | 2020-09-22 |
| 1174139356 | Ronald J Belczyk, Dpm Inc. | Podiatrist | 4911 Van Nuys Blvd Ste 100, Sherman Oaks, CA 91403-1746 | 2020-09-22 |
| 1093327231 | Upperline Healthcare California PC | Podiatrist | 2131 San Joaquin Hills Rd, Newport Beach, CA 92660-6507 | 2020-08-19 |
| 1841815545 | Kenny Au Quach | Podiatrist | 17100 Euclid St # 4004, Fountain Valley, CA 92708-4004 | 2020-06-09 |
| 1417579129 | Central California Leg, Foot, and Ankle Center, Inc. | Podiatrist | 11325 Park Square Dr Apt D204, Bakersfield, CA 93311-8854 | 2020-05-15 |
| 1487282109 | Laura Y Lee, Dpm Inc | Podiatrist | 5525 Forestwood Dr, Sacramento, CA 95842-2128 | 2020-03-29 |
| 1780211458 | Dupontdpm Inc. | Podiatrist | 651 1st St W Ste C, Sonoma, CA 95476-7046 | 2020-03-24 |
| 1659903722 | Bay Area Foot Care, Inc | Podiatrist | 5924 Stoneridge Dr Ste 102, Pleasanton, CA 94588-2750 | 2020-02-06 |
| 1780215210 | Albert Elhiani Dpm Inc | Podiatrist | 9340 W Pico Blvd Ste 2, Los Angeles, CA 90035-1255 | 2020-02-03 |
| Find all providers with the same taxonomy | ||||
| City | PANORAMA CITY |
| Zip Code | 91402 |
Please comment or provide details below to improve the information on BLAIR MOYLE JOLLEY.
| 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.