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General NPI Number Information
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NPI Number | 1194375295
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Entity Type | Organization
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Legal Business Name | BERKELEY FOOT AND ANKLE PODIATRY GROUP, INC
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Dates
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Enumeration Date | 09/19/2019
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Last Update Date | 02/02/2024
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Provider Practice Location Address
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Address Line | 3000 COLBY ST STE 104
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City | BERKELEY
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State | CA
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Zip | 94705-2090
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Country | US
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Telephone | 510-849-3800
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Fax | 510-849-3810
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Provider Business Mailing Address
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Address Line | 3000 COLBY ST STE 104
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City | BERKELEY
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State | CA
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Zip | 94705-2090
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Country | US
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Telephone | 510-849-3800
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Fax | 510-849-3810
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JONATHAN KENNETH HUEY
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Credential | DPM
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Telephone | 510-849-3800
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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 |
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License Number State |
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