DELTA PODIATRY GROUP, INC. (NPI# 1023169471) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023169471 |
| Entity Type | Organization |
| Organization Name | DELTA PODIATRY GROUP, INC. |
| Practice Address |
1205 N Hunter St Stockton CA 95202-1409 |
| Practice Telephone | 2094647367 |
| Practice Fax Number | 2094641801 |
| Mailing Telephone | 2094647367 |
| Mailing Fax Number | 2094641801 |
| Enumeration Date | 2007-01-14 |
| Last Update Date | 2009-04-02 |
| Authorized Official Name | LYNN ROBERT JOHNSON (PRESIDENT) |
| Authorized Official Telephone | 2094647367 |
| Authorized Official Credential | DPM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | E1406 | CA | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | ZZZ73253Z | 05 | |
| CA | LICENSE NUMBER | E1406 | 01 |
| Street Address |
1205 N HUNTER ST |
| City | STOCKTON |
| State | CA |
| Zip Code | 95202-1409 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619949187 | Lynn Robert Johnson | Podiatrist | 1205 N Hunter St, Stockton, CA 95202-1409 | 2006-02-07 |
| 1427022995 | Weldon R Hess | Podiatrist | 1205 N Hunter St, Stockton, CA 95202-1409 | 2006-02-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336774678 | Lecletus Griffin Jr. | Counselor | 1212 N. Califronia Street, Stockton, CA 95202 | 2020-03-06 |
| 1861035586 | Andrea Mn Perkins | Social Worker | Sjc Bhs Bacop, 1149 El Dorado Street, Stockton, CA 95202 | 2019-10-25 |
| 1932664620 | San Joaquin County Behavioral Health Services | Community/Behavioral Health | 1212 N. Califorian St, Stockton, CA 95202 | 2019-02-06 |
| 1730655895 | Jenaiah La'neise Sauceda | Social Worker | 343 E Main St Ste 918, Stockton, CA 95202 | 2018-10-16 |
| 1235631722 | Parker Yang | Counselor | 1111 N. El Dorado St, Stockton, CA 95202 | 2018-03-01 |
| 1912406976 | Janet Mendoza | Social Worker | 6 South Eldorado Street, Stockton, CA 95202 | 2018-02-06 |
| 1487162087 | Linda Soun | Counselor | 1111 N. El Dorado Street, Stockton, CA 95202 | 2018-01-17 |
| 1124545355 | Suleyma Velesquez | Counselor | 445 N. San Joaquin St., Stockton, CA 95202 | 2017-08-28 |
| 1821513946 | Savoeun Phal | Counselor | 1212 N California St Ste A214, Stockton, CA 95202 | 2017-08-09 |
| 1861921272 | Mandeep K Minhas | Registered Nurse | 1212 California St, Stockton, CA 95202 | 2017-06-08 |
| Find all providers in zip 95202 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144548439 | Michael D Mc Gavic A Professional Corporation | Podiatrist | 1755 W Hammer Ln, S-7b, Stockton, CA 95209-2900 | 2010-05-11 |
| 1588771273 | Katherine Y. Young | Podiatrist | 1810 Grand Canal Blvd, Suite 2, Stockton, CA 95207-8110 | 2006-08-25 |
| 1912919358 | Valley Podiatry Group Inc | Podiatrist | 3031 W March Lane, Suite 310, Stockton, CA 95219-6500 | 2006-08-13 |
| 1003868100 | Craig Anthony Lenz | Podiatrist | 1755 W Hammer Ln Ste 7b, Stockton, CA 95209-2900 | 2006-05-17 |
| 1629028923 | Craig Steven Garfolo | Podiatrist | 1350 W Robinhood Dr, Suite 14, Stockton, CA 95207-5512 | 2006-05-10 |
| 1619949187 | Lynn Robert Johnson | Podiatrist | 1205 N Hunter St, Stockton, CA 95202-1409 | 2006-02-07 |
| 1972599355 | Gregory T Pulas | Podiatrist | 3031 W March Ln, 203, Stockton, CA 95219-6500 | 2005-09-21 |
| 1073732913 | Darrell G Paul | Podiatrist | 7373 West Ln, Stockton, CA 95210-3377 | 2007-04-25 |
| 1346314945 | Thomas R. Ecton | Podiatrist | 7373 West Ln, Stockton, CA 95210-3377 | 2006-11-17 |
| 1902984818 | Curtis K. Lawlor | Podiatrist | 7373 West Ln, Stockton, CA 95210-3377 | 2006-11-01 |
| Find all providers in STOCKTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.