Healthcare Provider Details

I. General information

NPI: 1376293431
Provider Name (Legal Business Name): ALEXANDER REYZELMAN D P M INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2022
Last Update Date: 04/09/2022
Certification Date: 04/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 SHRADER ST STE 580
SAN FRANCISCO CA
94117-1016
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 415-759-2014
  • Fax: 415-759-2015
Mailing address:
  • Phone: 415-680-0871
  • Fax: 855-621-1883

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