Organization
PACIFIC POINT PODIATRY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TEA NGUYEN (CEO/OWNER)
(831) 708-1110
Entity
Organization
Contact information
Practice address
243 GREEN VALLEY RD STE A, FREEDOM, CA 95019-3133
(831) 288-3400
(877) 345-6920
Mailing address
243 GREEN VALLEY RD STE A, FREEDOM, CA 95019-3133
(831) 288-3400
(877) 345-6920
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
5256
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1811282494
INDIVIDUAL
—
Enumeration date
07/30/2018
Last updated
02/17/2020
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