Healthcare Provider Details

I. General information

NPI: 1144643289
Provider Name (Legal Business Name): CALIFORNIA FOOT AND ANKLE GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2014
Last Update Date: 11/14/2024
Certification Date: 11/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13420 NEWPORT AVE STE E
TUSTIN CA
92780-3745
US

IV. Provider business mailing address

13420 NEWPORT AVE STE E
TUSTIN CA
92780-3745
US

V. Phone/Fax

Practice location:
  • Phone: 714-352-5550
  • Fax: 714-352-5599
Mailing address:
  • Phone: 714-352-5550
  • Fax: 714-352-5599

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: DR. BENJAMIN SAVASKY
Title or Position: PRESIDENT
Credential: DPM
Phone: 248-808-9072