1619152352 NPI number — JEFFREY H. KATZ, D.P.M., INC.

Table of content: (NPI 1619152352)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619152352 NPI number — JEFFREY H. KATZ, D.P.M., INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JEFFREY H. KATZ, D.P.M., INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1619152352
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/26/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6200 E CANYON RIM RD
Provider Second Line Business Mailing Address:
SUITE 111E
Provider Business Mailing Address City Name:
ANAHEIM
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92807-4317
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
714-974-3338
Provider Business Mailing Address Fax Number:
714-974-7683

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1881 CALIFORNIA AVE
Provider Second Line Business Practice Location Address:
SUITE 102
Provider Business Practice Location Address City Name:
CORONA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92881-7299
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
951-735-8806
Provider Business Practice Location Address Fax Number:
951-735-6813
Provider Enumeration Date:
12/31/2007

Additional Information

Authorized Official

Authorized Official Last Name:
KATZ
Authorized Official First Name:
JEFFREY
Authorized Official Middle Name:
H.
Authorized Official Title or Position:
PODIATRIST
Authorized Official Telephone Number:
714-974-3338

Provider Taxonomy Codes

  • Taxonomy code: 213ES0103X , with the licence number:  E3438 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000E34380 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com