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Johannes M. Neuendorf

Emergency Medicine

Allopathic & Osteopathic Physicians

10710 N Torrey Pines Rd, La Jolla, CA 92037-1035

PECOS Enrollment

This provider is enrolled in PECOS as JOHANNES NEUENDORF.

Based on the most recent information from CMS, provider Johannes M. Neuendorf is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 11:51 AM.

Profile Details

Provider ID
1154388601
Provider Type
Individual
Full Name
Neuendorf, Johannes M.
Credential
D.O.

Gender
Male
Sole Proprietor
Yes
Enumeration Date
4/27/2006
Last Updated
11/6/2020

Contact Information

Practice Location

10710 N Torrey Pines Rd, La Jolla, CA 92037-1035

(858) 554-8638

(858) 554-9283

Mailing Location

10790 Rancho Bernardo Rd, San Diego, CA 92127-5705

(858) 554-8638

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207P00000X Primary	Description Emergency Medicine Allopathic & Osteopathic Physicians	License 20A9506 California
Code 207Q00000X	Description Family Medicine Allopathic & Osteopathic Physicians	License 20A9506 California
Code 207Q00000X	Description Family Medicine Allopathic & Osteopathic Physicians	License L9392 Texas
Code 207P00000X	Description Emergency Medicine Allopathic & Osteopathic Physicians	License L9392 Texas

Johannes M. Neuendorf

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

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License

Code

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License

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