Provider Demographics
NPI:1689057572
Name:PAXTON, DAVID (DPM)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:PAXTON
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 1:1401 SPANOS CT STE 104
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95355-2811
Mailing Address - Country:US
Mailing Address - Phone:209-525-3150
Mailing Address - Fax:888-491-3281
Practice Address - Street 1:1401 SPANOS CT STE 104
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95355
Practice Address - Country:US
Practice Address - Phone:209-525-3150
Practice Address - Fax:888-491-3281
Is Sole Proprietor?:No
Enumeration Date:2015-07-09
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAE5413213ES0103X
IA078611213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery