Provider Demographics
NPI:1356312813
Name:PURTZ, HARVEY JOHN (DPM)
Entity Type:Individual
Prefix:DR
First Name:HARVEY
Middle Name:JOHN
Last Name:PURTZ
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3645 W SHAW AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93711-3206
Mailing Address - Country:US
Mailing Address - Phone:559-457-6800
Mailing Address - Fax:559-457-6890
Practice Address - Street 1:3645 W SHAW AVE STE 101
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-3206
Practice Address - Country:US
Practice Address - Phone:559-457-6800
Practice Address - Fax:559-457-6890
Is Sole Proprietor?:No
Enumeration Date:2006-01-31
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA13406363A00000X
CAE3278213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000E32780Medicaid
CA000E32781Medicare PIN
CA000E32780Medicare PIN
CAT11608Medicare UPIN