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General NPI Number Information
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NPI Number | 1447080882
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Entity Type | Organization
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Legal Business Name | ARTISAN FOOT AND ANKLE PODIATRIC SPECIALISTS INC
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Dates
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Enumeration Date | 08/01/2024
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Last Update Date | 08/01/2024
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Provider Practice Location Address
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Address Line | 26730 TOWNE CENTRE DR STE 204
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City | FOOTHILL RANCH
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State | CA
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Zip | 92610-2842
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Country | US
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Telephone | 949-272-0007
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Fax | 949-272-0006
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Provider Business Mailing Address
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Address Line | PO BOX 31502
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City | BELFAST
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State | ME
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Zip | 04915-0168
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Country | US
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Telephone | 415-645-4525
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Fax | 510-399-1364
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Authorized Official
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Title or Position | RCMO
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Name | ALEXANDER REYZELMAN
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Credential | DPM
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Telephone | 415-292-0638
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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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