Healthcare Provider Details

I. General information

NPI: 1932797347
Provider Name (Legal Business Name): ALEXANDER REYZELMAN, DPM, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2021
Last Update Date: 08/28/2021
Certification Date: 08/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

909 HYDE ST STE 230
SAN FRANCISCO CA
94109-4845
US

IV. Provider business mailing address

2299 POST ST STE 205
SAN FRANCISCO CA
94115-3473
US

V. Phone/Fax

Practice location:
  • Phone: 415-474-3668
  • Fax: 415-775-4589
Mailing address:
  • Phone: 415-680-0871
  • Fax: 800-808-1779

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: ROZANA REYZELMAN
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 415-680-0871