NPIMap

Organization Active NPI

Moellmer, Inc.

  • Foot & Ankle Surgery Podiatrist
  • San Bernardino, CA
National Provider Identifier
1972883536
Registry record updated Aug 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
E4602 Issued in CA
Legal business name
MOELLMER, INC.
Practice address
1762 N Waterman Ave
San Bernardino, CA 92404-5130
Phone
(909) 886-3668
Fax
(909) 886-5542
NPI assigned
Aug 26, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2011

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

Authorized official

Name
Rebecca Moellmer, DPM
Title
President
Phone
(310) 766-0200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X E4602 CA Primary

Addresses

Primary practice location

1762 N Waterman Ave
San Bernardino, CA 92404-5130

Mailing address

1762 N Waterman Ave
San Bernardino, CA 92404-5130
Phone (909) 886-3668

National Provider Directory

National Provider Directory
Tax ID family
Moellmer Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1314316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314316800000",
    "number": "1972883536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1762 N WATERMAN AVE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924045130",
            "telephone_number": "909-886-3668",
            "fax_number": "909-886-5542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1762 N WATERMAN AVE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924045130",
            "telephone_number": "909-886-3668",
            "fax_number": "909-886-5542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOELLMER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-26",
        "last_updated": "2011-08-26",
        "status": "A",
        "authorized_official_last_name": "MOELLMER",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-766-0200",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E4602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 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.