Provider Demographics
NPI:1740321520
Name:FELFOLDI, JAMES JOHN (DPM)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:JOHN
Last Name:FELFOLDI
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 1:3340 KEMPER ST STE 102
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92110-4907
Mailing Address - Country:US
Mailing Address - Phone:619-225-9601
Mailing Address - Fax:619-225-9606
Practice Address - Street 1:3340 KEMPER ST STE 102
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92110-4907
Practice Address - Country:US
Practice Address - Phone:619-225-9601
Practice Address - Fax:619-225-9606
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE1701213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
T11033Medicare UPIN
CA5586540001Medicare NSC