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General NPI Number Information
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NPI Number | 1912640905
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Entity Type | Organization
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Legal Business Name | BAY AREA FOOT CARE, INC
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Dates
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Enumeration Date | 04/18/2022
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Last Update Date | 07/01/2024
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Provider Practice Location Address
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Address Line | 1600 CREEKSIDE DR STE 3100
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City | FOLSOM
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State | CA
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Zip | 95630-3486
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Country | US
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Telephone | 916-983-8555
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Fax | 916-435-5231
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Provider Business Mailing Address
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Address Line | 20130 LAKE CHABOT RD STE 202
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City | CASTRO VALLEY
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State | CA
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Zip | 94546-5340
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Country | US
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Telephone | 510-581-1484
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Fax | 510-581-7779
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Authorized Official
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Title or Position | CREDENTIALING MANAGER
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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 | 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 #2
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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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