Provider Demographics
NPI:1457546335
Name:STAINKAMP, JOHN A (DPM)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:A
Last Name:STAINKAMP
Suffix:
Gender:M
Credentials:DPM
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Mailing Address - Street 1:22110 ROSCOE BLVD
Mailing Address - Street 2:#201
Mailing Address - City:CANOGA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91304-3845
Mailing Address - Country:US
Mailing Address - Phone:818-716-6964
Mailing Address - Fax:818-716-1530
Practice Address - Street 1:22110 ROSCOE BLVD
Practice Address - Street 2:#201
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91304-3845
Practice Address - Country:US
Practice Address - Phone:818-716-6964
Practice Address - Fax:818-716-1530
Is Sole Proprietor?:No
Enumeration Date:2007-09-13
Last Update Date:2010-10-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAE2355213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWE2355AMedicare PIN
T11302Medicare UPIN