Pacific Diabetes Institute, Inc.

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

Legal business name

PACIFIC DIABETES INSTITUTE, INC.

Practice address

15107 Vanowen St
Amputation Prevention Center - 4 East
Van Nuys, CA 91405-4542

Phone

(818) 902-5755

Fax

(818) 904-3708

NPI assigned

Oct 30, 2012

Last updated

Oct 30, 2012By 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 Pougatsch, D.P.M.

Title

President/Ceo

Phone

(310) 869-8857

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1351555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351555200000",
    "number": "1710231626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 914",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902130914",
            "telephone_number": "310-869-8857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15107 VANOWEN ST",
            "address_2": "AMPUTATION PREVENTION CENTER - 4 EAST",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914054542",
            "telephone_number": "818-902-5755",
            "fax_number": "818-904-3708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC DIABETES INSTITUTE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-30",
        "last_updated": "2012-10-30",
        "status": "A",
        "authorized_official_last_name": "POUGATSCH",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "310-869-8857",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jazmine Annette Pacheco
• Pearl Pacheco
• Tanya Pacheco
• Pacific Asian Counseling Services
• Pacific Care Non-Emergency Medical Transportation Inc (Pacific Care Medcial Transportation)
• Pacific Oaks Medical Group Laboratories
• Pacific Ride Medical Transportation
• Pacifica Brain Health Residency Program
• Tjari Packard
• Daisy Gisel Padilla Reynoso

• Foot & Ankle Surgery Podiatrist in Van Nuys, CA
• Providers in Van Nuys, CA by specialty
• Foot & Ankle Surgery Podiatrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2012; 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.