Provider Demographics
NPI:1821238759
Name:INLOW, DEANNA L (DPM)
Entity Type:Individual
Prefix:
First Name:DEANNA
Middle Name:L
Last Name:INLOW
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:MRS
Other - First Name:DEANNA
Other - Middle Name:L
Other - Last Name:VENEMA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1873 HEIDELBERG DR
Mailing Address - Street 2:
Mailing Address - City:LIVERMORE
Mailing Address - State:CA
Mailing Address - Zip Code:94550-6112
Mailing Address - Country:US
Mailing Address - Phone:925-922-1329
Mailing Address - Fax:925-371-1003
Practice Address - Street 1:5 HARRIS CT BLDG T
Practice Address - Street 2:SUITE 103
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-5750
Practice Address - Country:US
Practice Address - Phone:831-373-3839
Practice Address - Fax:831-375-8804
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-05
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4820213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACN646AMedicare PIN