Provider Demographics
NPI:1730683418
Name:AMEHA T. JOBA,DPM, PC
Entity type:Organization
Organization Name:AMEHA T. JOBA,DPM, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:AMEHA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOBA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:707-586-9300
Mailing Address - Street 1:1350 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:ROHNERT PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94928-2932
Mailing Address - Country:US
Mailing Address - Phone:707-586-9300
Mailing Address - Fax:
Practice Address - Street 1:1350 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:ROHNERT PARK
Practice Address - State:CA
Practice Address - Zip Code:94928-2932
Practice Address - Country:US
Practice Address - Phone:707-586-9300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-19
Last Update Date:2018-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE5244213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty