Healthcare Provider Details

I. General information

NPI: 1164031795
Provider Name (Legal Business Name): BIJAN F. SHEIKHIZADEH DPM PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2020
Last Update Date: 07/30/2020
Certification Date: 07/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 N EL CAMINO REAL STE 201
ENCINITAS CA
92024-1335
US

IV. Provider business mailing address

501 N EL CAMINO REAL STE 201
ENCINITAS CA
92024-1335
US

V. Phone/Fax

Practice location:
  • Phone: 760-436-8667
  • Fax: 760-436-2292
Mailing address:
  • Phone: 760-436-8667
  • Fax: 760-436-2292

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: BIJAN FARHAD SHEIKHIZADEH
Title or Position: OWNER/PHYSICIAN
Credential: DPM
Phone: 360-888-7553