Dr. Sean Michael Dougherty
Podiatrist Sports Medicine Foot & Ankle Surgery Primary Podiatric Medicine
1620 Pennsylvania Ave Ste A
Fairfield
, California 94533-3509
Dr. Sean Michael Dougherty
Podiatrist Sports Medicine Foot & Ankle Surgery Primary Podiatric Medicine
1620 Pennsylvania Ave Ste A
Fairfield
, California 94533-3509
(707) 426-3156
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About
Features
Specialties
- Podiatrist
- Primary Podiatric Medicine
- Sports Medicine
- Foot & Ankle Surgery
Languages spoken
- English
Location
First Address
- Dr. Sean Michael Dougherty
- 1620 Pennsylvania Ave Ste A
- Fairfield, CA
- Zip : 94533-3509
- Fax : (707) 426-3156
- Phone : (707) 426-5644
Second Address
- Dr. Sean Michael Dougherty
- 1620 Pennsylvania Ave Ste A
- Fairfield, CA
- Zip : 94533-3509
- Fax : (707) 426-3156
- Phone : (707) 426-5644
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FAQs
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Is Dr. Sean Michael Dougherty a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 213E00000X | Podiatrist | E5009 | CA |
| N | 222Z00000X | Podiatrist | E5009 | CA |
| N | 213EP1101X | Primary Podiatric Medicine | E5009 | CA |
| N | 2081S0010X | Sports Medicine | E5009 | CA |
| N | 213ES0000X | Sports Medicine | E5009 | CA |
| Y | 213ES0103X | Foot & Ankle Surgery | E5009 | CA |
National Provider Identifier
| NPI | 1407089261 |
|---|---|
| Provider Name | Dr. Sean Michael Dougherty |
| First Address | Fairfield, CA 94533-3509 |
| Second Address | Fairfield, CA 94533-3509 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 27/08/2009 |
| Last Update Date | 02/09/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| P01083197 | MEDICARE RAILROAD (01) | CA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.