Provider Demographics
NPI:1770685299
Name:DIETZ, JAMES FRANCIS (DPM)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:FRANCIS
Last Name:DIETZ
Suffix:
Gender:M
Credentials:DPM
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Other - Credentials:
Mailing Address - Street 1:203 E BLITHEDALE AVE
Mailing Address - Street 2:STE B
Mailing Address - City:MILL VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94941-2046
Mailing Address - Country:US
Mailing Address - Phone:415-381-0330
Mailing Address - Fax:415-381-5319
Practice Address - Street 1:203 E BLITHEDALE AVE
Practice Address - Street 2:STE B
Practice Address - City:MILL VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94941-2046
Practice Address - Country:US
Practice Address - Phone:415-381-0330
Practice Address - Fax:415-381-5319
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-04
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAE2122213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000E2122Medicare ID - Type Unspecified
CAT11182Medicare UPIN