Healthcare Provider Details

I. General information

NPI: 1902935091
Provider Name (Legal Business Name): VALLEY FOOT AND ANKLE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 09/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5400 BALBOA BLVD SUITE 120
ENCINO CA
91316-1502
US

IV. Provider business mailing address

5400 BALBOA BLVD SUITE 120
ENCINO CA
91316-1502
US

V. Phone/Fax

Practice location:
  • Phone: 818-907-6102
  • Fax: 866-513-4995
Mailing address:
  • Phone: 818-907-6102
  • Fax: 866-513-4995

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: DAWN BURATTI
Title or Position: PRESIDENT
Credential: DPM
Phone: 818-907-6102