Unknown Individual – Podiatrist, NPI 1972501344

Unknown Individual is a healthcare provider. based in San diego, California. specializing in Podiatrist. They hold a License No. E1417 (CA). The NPI Number for Unknown Individual is 1972501344

Main info

Organization
Inactive
61 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1972501344
Phone
(619) 282-8781
Address
4657 E TALMADGE DR
Deactivation Date
2 June 2022

Doctor Profile

Medical School Name
KENT STATE UNIVERSITY COLLEGE OF PODIATRIC MEDICINE
Secondary Phone
6192828781
Graduation Year
1965 (61 years ago)
PAC ID
5193901387
Professional Enrollment ID
I20110524000680
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 4657, East Talmadge Drive, Kensington, City Heights, San Diego, San Diego County, California, 92116, United States

    SAN DIEGO, CA 921164829

    Phone: (619) 282-8781

    Fax: (619) 282-8781

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 92116)

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Reviews

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Frequently asked questions

How is Unknown Individual identified in CMS data?
CMS-hosted NPPES data lists Unknown Individual with NPI 1972501344.
Is Unknown Individual's NPI deactivated?
The extract indicates Unknown Individual is not in an active NPI state.
What taxonomy line describes Unknown Individual?
For research purposes, treat Unknown Individual as Podiatrist in this dataset. Clinical services aligned with this taxonomy classification.
What address line appears for Unknown Individual?
Unknown Individual's geographic hint is San Diego, California in our summary view.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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