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General NPI Number Information
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NPI Number | 1831300078
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Entity Type | Organization
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Legal Business Name | ROSALINE FOOT CARE A PODIATRY GROUP, INC.
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Dates
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Enumeration Date | 05/25/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1950 ROSALINE AVE SUITE F
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City | REDDING
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State | CA
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Zip | 96001-2543
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Country | US
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Telephone | 530-244-3338
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Fax | 530-244-3342
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Provider Business Mailing Address
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Address Line | 1950 ROSALINE AVE SUITE F
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City | REDDING
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State | CA
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Zip | 96001-2543
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Country | US
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Telephone | 530-244-3338
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Fax | 530-244-3342
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN CHARLES WILLIAMS
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Credential | M.D.
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Telephone | 530-244-3338
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 284300000X
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Taxonomy Name | Special Hospital
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License Number | ZZZ24148Z
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License Number State | CA
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