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General NPI Number Information
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NPI Number | 1033534607
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Entity Type | Organization
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Legal Business Name | NAPA FOOT AND ANKLE INC.
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Dates
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Enumeration Date | 02/19/2014
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Last Update Date | 06/23/2015
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Provider Practice Location Address
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Address Line | 935 TRANCAS ST 2C
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City | NAPA
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State | CA
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Zip | 94558-2932
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Country | US
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Telephone | 707-259-0766
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Fax | 707-259-0183
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Provider Business Mailing Address
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Address Line | 935 TRANCAS ST 2C
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City | NAPA
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State | CA
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Zip | 94558-2932
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Country | US
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Telephone | 707-259-0766
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Fax | 707-259-0183
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | DR. SKY SHANKS
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Credential | DPM
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Telephone | 707-259-0776
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | E5106
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License Number State | CA
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