David L Dutra DPM Inc

Primary specialty

PodiatristTaxonomy code 213E00000X

License

E3190 Issued in CA

Legal business name

DAVID L DUTRA DPM INC

Practice address

613 New York Ranch Rd
Jackson, CA 95642-9328

Phone

(209) 223-3030

Fax

(209) 223-5864

NPI assigned

Mar 28, 2007

Last updated

Apr 27, 2011By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. David L Dutra, D.P.M.NPI 1700989118

Title

Owner President

Phone

(209) 223-3030

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• David Lee Dutra, DPM

  • Podiatrist
  • Jackson, CA
  • NPI 1700989118
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303862400000",
    "number": "1043339328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 938",
            "city": "JACKSON",
            "state": "CA",
            "postal_code": "956420938",
            "telephone_number": "209-223-3030",
            "fax_number": "209-223-5864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "613 NEW YORK RANCH RD",
            "city": "JACKSON",
            "state": "CA",
            "postal_code": "956429328",
            "telephone_number": "209-223-3030",
            "fax_number": "209-223-5864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID L DUTRA DPM INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2011-04-27",
        "status": "A",
        "authorized_official_last_name": "DUTRA",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "209-223-3030",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E3190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wendy Cranford
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• Cynthia Caryn Custer-Coon, PHARMD
• Geralyn Da Silva
• Cailey Dante, PA-C
• David M Melniczek MD Inc (NorCal Surgical Group)
• David R Bruce DO Inc (Jackson Dermatology)
• Aushai De Vance
• Adam Clementi Delgado, DO
• Denise Mathre Chiropractic Corporation (Achieving Balance Chiropractic)

• Podiatrist in Jackson, CA
• Providers in Jackson, CA by specialty
• Podiatrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.