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Organization

RICHARD M AND DONALD R GREEN PTRS DBA SAN DIEGO PODIATRY GROUP

Active
Other names
San Diego Podiatry Group
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BENJAMIN CULLEN DPM (PODIATRIST)
(619) 291-0777
Entity
Organization

Contact information

Practice address
2650 CAMINO DEL RIO N, SUITE 101, SAN DIEGO, CA 92108-1621
(619) 291-0777
(619) 291-3231
Mailing address
2650 CAMINO DEL RIO N, SUITE 101, SAN DIEGO, CA 92108-1621
(619) 291-0777
(619) 291-3231

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
GRE000300
CA
01
ZZZ40809Z
BLUE SHIELD
CA
Enumeration date
05/20/2006
Last updated
04/07/2017
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