Provider Demographics
NPI:1043389026
Name:DUSTIN, ADAM F (DPM)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:F
Last Name:DUSTIN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:326 ENCINITAS BLVD
Mailing Address - Street 2:STE 100
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-8703
Mailing Address - Country:US
Mailing Address - Phone:760-436-5533
Mailing Address - Fax:760-436-0611
Practice Address - Street 1:326 ENCINITAS BLVD
Practice Address - Street 2:STE 100
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-8703
Practice Address - Country:US
Practice Address - Phone:760-436-5533
Practice Address - Fax:760-436-0611
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2016-02-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAE4254213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00E425400Medicaid
CA00E425400Medicaid
CAE4254Medicare PIN