Organization Active NPI

William G Goldblatt DPM a Professional Corporation

  • Podiatrist
  • San Dimas, CA
National Provider Identifier
1710118138
Registry record updated Sep 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
WILLIAM G GOLDBLATT DPM A PROFESSIONAL CORPORATION
Practice address
322 N San Dimas Ave
San Dimas, CA 91773-2601
Phone
(909) 592-4438
Fax
(909) 592-4439
NPI assigned
Aug 3, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2010

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

Authorized official

Name
Dr. William Gerald Goldblatt, DPMNPI 1467420802
Title
A Professional Corporation
Phone
(909) 592-4438

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X Primary

Addresses

Primary practice location

322 N San Dimas Ave
San Dimas, CA 91773-2601

Mailing address

322 N San Dimas Ave
San Dimas, CA 91773-2601
Phone (909) 592-4438

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101008000179 CA Part B Supplier - Clinic/Group Practice 0042402091 Receives reassigned benefits from 1 practitioner
Practice locations: San Dimas, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1249257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285200000000",
    "number": "1710118138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 N SAN DIMAS AVE",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917732601",
            "telephone_number": "909-592-4438",
            "fax_number": "909-592-4439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 N SAN DIMAS AVE",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917732601",
            "telephone_number": "909-592-4438",
            "fax_number": "909-592-4439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM G GOLDBLATT DPM A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-03",
        "last_updated": "2010-09-23",
        "status": "A",
        "authorized_official_last_name": "GOLDBLATT",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "GERALD",
        "authorized_official_title_or_position": "A PROFESSIONAL CORPORATION",
        "authorized_official_telephone_number": "909-592-4438",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Dimas, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.