Individual
JAMES W BREEDLOVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D P M
Contact information
Practice address
275 MARINA ST, MORRO BAY, CA 93442-2244
(805) 543-3025
(805) 543-2740
Mailing address
275 MARINA ST, MORRO BAY, CA 93442-2244
(805) 543-3025
(805) 543-2740
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
E3976
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000E39760
—
CA
01
—
480021688
RAILROAD MEDICARE
CA
Enumeration date
09/09/2005
Last updated
04/10/2024
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