Pacific Point Podiatry Inc

Primary specialty

Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X

License

5256

Legal business name

PACIFIC POINT PODIATRY INC

Practice address

243 Green Valley Rd Ste a
Freedom, CA 95019-3133

Phone

(831) 288-3400

Fax

(877) 345-6920

NPI assigned

Jul 30, 2018

Organization subpart

No

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

Authorized official

Name

Tea Nguyen

Title

Ceo/Owner

Phone

(831) 708-1110

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sargon Jacob

  • Anesthesiology Physician
  • Santa Cruz, CA
  • NPI 1497725220
  NPD (past)

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

{
    "created_epoch": "1532908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581897600000",
    "number": "1679051932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "243 GREEN VALLEY RD STE A",
            "city": "FREEDOM",
            "state": "CA",
            "postal_code": "950193133",
            "telephone_number": "831-288-3400",
            "fax_number": "877-345-6920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "243 GREEN VALLEY RD STE A",
            "city": "FREEDOM",
            "state": "CA",
            "postal_code": "950193133",
            "telephone_number": "831-288-3400",
            "fax_number": "877-345-6920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC POINT PODIATRY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-30",
        "last_updated": "2020-02-17",
        "certification_date": "2020-02-17",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "TEA",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "831-708-1110"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": null,
            "license": "5256",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL",
            "identifier": "1811282494",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Primary Podiatric Medicine Podiatrist in Freedom, CA
• Providers in Freedom, CA by specialty
• Primary Podiatric Medicine Podiatrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2020; 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.