Doctor Name: | KEVIN IRVING STROH |
NPI Number: | 1104829431 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DPM |
License Number: | E34670 |
Business Practice Address: | 1300 W Lodi Ave Ste W Lodi, CA - 952423037 |
Business Phone Number: | 2093346664 |
Business Fax Number: | 2093342379 |
Mailing Address: | 1300 W Lodi Ave, Ste W LODI |
State: | CA |
Postal Code: | 952423037 |
Phone Number: | 2093346664 |
Fax Number: | 2093342379 |
NPI Enumeration Date: | 05/31/2005 |
NPI Last Update Date: | 05/19/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | E34670 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CA |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |