Pacific Coast Podiatry PC
NPI #1285080978 in San Bernardino, California
Provider Information
- NPI Number
- 1285080978
- Entity Type
- Organization
- Organization Name
- Pacific Coast Podiatry PC
- Primary Specialty
- Preferred Provider Organization
- Enumeration Date
- May 11, 2016
- Last Updated
- Jun 20, 2022
Practice Location
- Address
- 1762 N WATERMAN AVE
- City
- San Bernardino
- State
- California
- ZIP Code
- 92404-5130
- Phone
- (909) 886-3668
Authorized Official
- Name
- DR. CLAYTON GARY JOHNSEN, D.P.M
- Title
- OWNER
- Phone
- (909) 886-3668
Specialties & Taxonomy Codes
| Specialty |
|---|
| Preferred Provider Organization |
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