Individual provider · Type 1 NPI
Ryan Jacob Boettger, DPM
Foot & Ankle Surgery Podiatrist · San Diego, CA
NPI number
1104492974
Active
Practice location
4077 Fifth Ave # MER-35
San Diego, CA 92103-2105
Mailing address
4077 Fifth Ave # MER35
San Diego, CA 92103-2105
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Foot & Ankle Surgery Podiatrist Primary | 213ES0103X | E6115 (CA) |
Foot & Ankle Surgery Podiatrist: Definition to come...
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About NPI 1104492974
Ryan Jacob Boettger, DPM's National Provider Identifier is 1104492974, issued on Jun 1, 2021. The primary taxonomy on file is Foot & Ankle Surgery Podiatrist (213ES0103X), and the practice location is in San Diego, CA. The record was last updated on Aug 6, 2026.