| Jack A Koch, DPM | |
|
425 W Bonita Ave Ste 110, San Dimas, CA 91773-2543 | |
| (714) 990-9153 | |
| (714) 990-9154 |
| Full Name | Jack A Koch |
|---|---|
| Gender | Male |
| Speciality | Podiatrist |
| Location | 425 W Bonita Ave Ste 110, San Dimas, California |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447275748 | NPI | - | NPPES |
| 000E22551 | Medicaid | CA | |
| 480005415 | Other | CA | RAILROAD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 213E00000X | Podiatrist | E2255 (California) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Jack A Koch, DPM 2937 Cardamon Ln, Fullerton, CA 92835-4307 Ph: (714) 990-9153 | Jack A Koch, DPM 425 W Bonita Ave Ste 110, San Dimas, CA 91773-2543 Ph: (714) 990-9153 |
Thomas E Smith Dpm Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 425 W Bonita Ave Ste 110, San Dimas, CA 91773 Phone: 909-599-0981 Fax: 909-592-0738 | |
Dr. Edwin Oghoorian, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 150 W Foothill Blvd Unit F, San Dimas, CA 91773 Phone: 626-385-3338 Fax: 626-914-4119 | |
Ira A Diamond, DPM Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 425 W Bonita Ave Ste 110, San Dimas, CA 91773 Phone: 909-599-0981 Fax: 909-592-0738 | |
Walker Podiatry Group Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 425 W Bonita Ave Ste 110, San Dimas, CA 91773 Phone: 909-599-0981 Fax: 909-592-0738 | |
Thomas E Smith, DPM Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 425 W Bonita Ave Ste 110, San Dimas, CA 91773 Phone: 909-599-0981 Fax: 909-592-0738 | |
West La Foot Doctor Inc. Podiatrist Medicare: Medicare Enrolled Practice Location: 425 W Bonita Ave Ste 110, San Dimas, CA 91773 Phone: 909-599-0981 Fax: 909-592-0738 |