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General NPI Number Information
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NPI Number | 1972808384
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Entity Type | Organization
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Legal Business Name | PEAK FOOT AND ANKLE SPECIALISTS, INC
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Dates
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Enumeration Date | 01/14/2011
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Last Update Date | 09/13/2012
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Provider Practice Location Address
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Address Line | 13851 E 14TH ST STE 308
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City | SAN LEANDRO
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State | CA
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Zip | 94578-2631
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Country | US
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Telephone | 510-927-6584
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Fax | 510-686-8786
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Provider Business Mailing Address
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Address Line | 13851 E 14TH ST STE 308
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City | SAN LEANDRO
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State | CA
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Zip | 94578-2631
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Country | US
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Telephone | 510-927-6584
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Fax | 510-686-8786
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Authorized Official
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Title or Position | PHYSICIAN/SURGEON
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Name | EKTA SHAH
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Credential | DPM
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Telephone | 510-927-6584
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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 | E4668
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License Number State | CA
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