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
—
—
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
G67534
CA
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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