Healthcare Provider Details

I. General information

NPI: 1720836430
Provider Name (Legal Business Name): PRECISION FOOT AND ANKLE INSTITUTE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2024
Last Update Date: 05/08/2024
Certification Date: 05/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3655 LOMITA BLVD STE 120
TORRANCE CA
90505-1907
US

IV. Provider business mailing address

3655 LOMITA BLVD STE 120
TORRANCE CA
90505-1907
US

V. Phone/Fax

Practice location:
  • Phone: 310-791-1092
  • Fax: 310-791-1087
Mailing address:
  • Phone: 310-791-1092
  • Fax: 310-791-1087

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0000X
TaxonomySports Medicine Podiatrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State

VIII. Authorized Official

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