Richard M and Donald R Green PTRS Dba San Diego Podiatry Group

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

Legal business name

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

Practice address

2650 Camino del Rio N
Suite 101
San Diego, CA 92108-1621

Phone

(619) 291-0777

Fax

(619) 291-3231

NPI assigned

May 20, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Benjamin Cullen, DPMNPI 1851652309

Title

Podiatrist

Phone

(619) 291-0777

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• San Diego Podiatry Group Doing business as

Locations

Practitioners 1

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

• Benjamin Dennis Cullen, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • San Diego, CA
  • NPI 1851652309
  NPD Authorized official

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491523200000",
    "number": "1962456400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 CAMINO DEL RIO N",
            "address_2": "SUITE 101",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921081621",
            "telephone_number": "619-291-0777",
            "fax_number": "619-291-3231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 CAMINO DEL RIO N",
            "address_2": "SUITE 101",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921081621",
            "telephone_number": "619-291-0777",
            "fax_number": "619-291-3231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD M AND DONALD R GREEN PTRS DBA SAN DIEGO PODIATRY GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-20",
        "last_updated": "2017-04-07",
        "status": "A",
        "authorized_official_last_name": "CULLEN",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "PODIATRIST",
        "authorized_official_telephone_number": "619-291-0777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ40809Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GRE000300",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "San Diego Podiatry Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Foot & Ankle Surgery Podiatrist in San Diego, CA
• Providers in San Diego, 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 Apr 7, 2017; 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.