Organization
PACIFIC COAST PODIATRY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CLAYTON GARY JOHNSEN D.P.M (OWNER)
(909) 886-3668
Entity
Organization
Contact information
Practice address
1762 N WATERMAN AVE, SAN BERNARDINO, CA 92404-5130
(909) 886-3668
(909) 886-5542
Mailing address
1762 N WATERMAN AVE, SAN BERNARDINO, CA 92404-5130
(909) 886-3668
(909) 886-5542
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
E4834
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1285080978
NPI
—
Enumeration date
05/11/2016
Last updated
06/20/2022
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us