Healthcare Provider Details

I. General information

NPI: 1124849955
Provider Name (Legal Business Name): ALLIANCE FOOT AND ANKLE INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2024
Last Update Date: 10/23/2024
Certification Date: 10/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

234 E COMMONWEALTH AVE STE 200
FULLERTON CA
92832-1911
US

IV. Provider business mailing address

234 E COMMONWEALTH AVE STE 200
FULLERTON CA
92832-1911
US

V. Phone/Fax

Practice location:
  • Phone: 714-739-5959
  • Fax: 714-452-1986
Mailing address:
  • Phone: 714-739-5959
  • Fax: 714-452-1986

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: ALI ANAIM
Title or Position: PRESIDENT
Credential: DPM
Phone: 714-739-5959