Healthcare Provider Details

I. General information

NPI: 1275244659
Provider Name (Legal Business Name): BAY AREA FOOT CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/07/2022
Last Update Date: 02/18/2025
Certification Date: 02/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6600 MERCY CT STE 260
FAIR OAKS CA
95628-3190
US

IV. Provider business mailing address

PO BOX 25576
BELFAST ME
04915-2006
US

V. Phone/Fax

Practice location:
  • Phone: 916-961-3434
  • Fax: 916-844-0285
Mailing address:
  • Phone: 415-645-4525
  • Fax: 510-399-1364

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: ALEXANDER REYZELMAN
Title or Position: REGIONAL CHIEF MEDICAL OFFICER
Credential: DPM
Phone: 415-292-0638