Individual
KENNETH JAY WEPMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
E3594
CA
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
E3594
CA
213ER0200X
Radiology Podiatrist
E3594
CA
213ES0000X
Sports Medicine Podiatrist
E3594
CA
213ES0131X
Foot Surgery Podiatrist
E3594
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000E35940
—
CA
01
—
0826880001
DME
CA
01
—
330426137
FEDERAL TAX ID
CA
Enumeration date
07/09/2006
Last updated
07/18/2024
Update your record
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