Provider Demographics
NPI:1518923614
Name:KATZ, JEFFREY H (DPM)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:H
Last Name:KATZ
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 1:6200 E CANYON RIM RD
Mailing Address - Street 2:SUITE 111E
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92807-4317
Mailing Address - Country:US
Mailing Address - Phone:714-974-3338
Mailing Address - Fax:714-974-7683
Practice Address - Street 1:6200 E CANYON RIM RD
Practice Address - Street 2:SUITE 111E
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92807-4317
Practice Address - Country:US
Practice Address - Phone:714-974-3338
Practice Address - Fax:714-974-7683
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE3438213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000E34380OtherBLUESHIELD IND - AHPG
CAE3438OtherBLUE CROSS
CA000E34380Medicaid
CA000E34381OtherBLUESHIELD IND - CORONA
CA4056488OtherAETNA - INDV.
CA480029094OtherMEDICARE RAILROAD
CA4399510001Medicare NSC
CA4056488OtherAETNA - INDV.
CAT19329Medicare UPIN
CA000E34380Medicaid