Healthcare Provider Details

I. General information

NPI: 1710186655
Provider Name (Legal Business Name): RONALD BELCZYK DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2007
Last Update Date: 03/07/2023
Certification Date: 09/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

903 W 7TH ST
OXNARD CA
93030-6755
US

IV. Provider business mailing address

19360 RINALDI ST STE 363
PORTER RANCH CA
91326-1607
US

V. Phone/Fax

Practice location:
  • Phone: 747-263-9696
  • Fax: 805-263-4090
Mailing address:
  • Phone: 866-895-8716
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberSC005767
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberE4906
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: