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Organization
DISORDERS OF THE FOOT AND ANKLE
Active
Organization
DISORDERS OF THE FOOT AND ANKLE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHARON MARIE DREEBEN MD (CEO)
(858) 488-4008
Entity
Organization
Contact information
Practice address
331 SEA RIDGE DRIVE, LA JOLLA, CA 92037
(858) 488-4008
(877) 297-2958
Mailing address
5580 LA JOLLA BLVD #55, LA JOLLA, CA 92037
(858) 488-4008
(877) 297-2958
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
NULL
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
G67534
CA
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
—
NULL
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G675340
—
CA
01
—
200045199
RAILROAD MEDICARE PTAN
CA
Enumeration date
06/23/2006
Last updated
01/13/2022
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