Organization
DAVID L DUTRA DPM INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID L DUTRA D.P.M. (OWNER PRESIDENT)
(209) 223-3030
Entity
Organization
Contact information
Practice address
613 NEW YORK RANCH RD, JACKSON, CA 95642-9328
(209) 223-3030
(209) 223-5864
Mailing address
PO BOX 938, JACKSON, CA 95642-0938
(209) 223-3030
(209) 223-5864
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
E3190
CA
Other
Enumeration date
03/28/2007
Last updated
04/27/2011
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