Healthcare Provider Details

I. General information

NPI: 1235992660
Provider Name (Legal Business Name): SYED AHMED FOOT & ANKLE CONSULTANTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2024
Last Update Date: 07/16/2024
Certification Date: 07/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 E 7TH ST
UPLAND CA
91786-6740
US

IV. Provider business mailing address

330 E 7TH ST FL 2
UPLAND CA
91786-6740
US

V. Phone/Fax

Practice location:
  • Phone: 909-931-3800
  • Fax:
Mailing address:
  • Phone: 949-836-4791
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SYED AHMED
Title or Position: PHYSICIAN
Credential: DPM
Phone: 949-836-4791