Organization
ADOBE FOOT CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CECILE SHEPARD (OWNER)
(925) 372-8780
Entity
Organization
Contact information
Practice address
2485 HIGH SCHOOL AVE STE 222, CONCORD, CA 94520-1813
(925) 372-8780
Mailing address
15 APRIL CT, PLEASANT HILL, CA 94523-2731
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
E28440
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000E28440
PIN & LICENSE
CA
01
—
000E28441
PPIN
CA
01
—
1528153889
INDIVIDUAL NPI
CA
01
—
E28440
STATE LICENSE
CA
01
—
ZZZ01511Z
MEDICARE GROUP #
CA
Enumeration date
04/12/2007
Last updated
11/08/2024
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