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General NPI Number Information
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NPI Number | 1487513156
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Entity Type | Organization
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Legal Business Name | UNIVERSITY FOOT AND ANKLE INSTITUTE A PODIATRIC SURGICAL CENTER
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Dates
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Enumeration Date | 01/19/2026
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Last Update Date | 01/19/2026
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Provider Practice Location Address
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Address Line | 1360 W 6TH ST STE 150
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City | SAN PEDRO
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State | CA
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Zip | 90732-3541
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Country | US
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Telephone | 310-548-1191
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 841868
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City | LOS ANGELES
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State | CA
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Zip | 90084-1868
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Country | US
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Telephone | 847-627-4920
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Fax |
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Authorized Official
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Title or Position | CMO
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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 | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #3
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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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