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General NPI Number Information
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NPI Number | 1548306590
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Entity Type | Organization
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Legal Business Name | MARINA PODIATRY ASSOCIATES INC
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Dates
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Enumeration Date | 01/29/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2477 CHESTNUT STREET
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City | SAN FRANCISCO
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State | CA
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Zip | 94123-2505
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Country | US
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Telephone | 415-921-1922
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Fax | 415-921-0771
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Provider Business Mailing Address
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Address Line | 2477 CHESTNUT STREET
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City | SAN FRANCISCO
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State | CA
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Zip | 94123-2505
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Country | US
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Telephone | 415-921-1922
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Fax | 415-921-0771
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RONALD H MICHAEL
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Credential | DPM
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Telephone | 415-921-1922
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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 | E1141
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License Number State | CA
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