Provider Demographics
NPI:1225182033
Name:JAMES J VONHOLLE
Entity Type:Organization
Organization Name:JAMES J VONHOLLE
Other - Org Name:FOOT SOLUTIONS RANCHO BERNARDO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:J
Authorized Official - Last Name:VONHOLLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-674-6263
Mailing Address - Street 1:11835 CARMEL MOUNTAIN RD
Mailing Address - Street 2:#1302
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92128-4609
Mailing Address - Country:US
Mailing Address - Phone:858-674-6263
Mailing Address - Fax:858-674-6249
Practice Address - Street 1:11835 CARMEL MOUNTAIN RD
Practice Address - Street 2:#1302
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92128-4609
Practice Address - Country:US
Practice Address - Phone:858-674-6263
Practice Address - Fax:858-674-6249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2009-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5236980001Medicare NSC