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General NPI Number Information
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NPI Number | 1932290178
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Entity Type | Organization
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Legal Business Name | ASSOCIATED PODIATRY GROUP OF SAN CARLOS
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Dates
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Enumeration Date | 09/27/2006
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Last Update Date | 08/18/2011
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Provider Practice Location Address
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Address Line | 961 LAUREL ST SUITE 100
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City | SAN CARLOS
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State | CA
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Zip | 94070-3949
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Country | US
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Telephone | 650-593-8083
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Fax | 650-593-9145
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Provider Business Mailing Address
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Address Line | 961 LAUREL ST SUITE 100
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City | SAN CARLOS
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State | CA
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Zip | 94070-3949
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Country | US
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Telephone | 650-593-8083
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Fax | 650-593-9145
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CURTIS D. LEVIANT
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Credential | D.P.M.
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Telephone | 650-593-8083
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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 | E3224
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | E3224
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License Number State | CA
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