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NPI Code Detail

MEDICARE: BAY AREA FOOT CARE, INC

MEDICARE: BAY AREA FOOT CARE, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WW0000XWound Care Registered Nurse
2213E00000XPodiatrist
3332B00000XDurable Medical Equipment & Medical Supplies
4213ES0103XFoot & Ankle Surgery Podiatrist

General Provider Information

NPI Number : 1073291738
Entity Type Code : Organization
Provider Name (Legal Business Name) : BAY AREA FOOT CARE, INC
Provider Business Mailing Address
First Line : 20130 LAKE CHABOT RD STE 202
Second Line :
City : CASTRO VALLEY
State : CA
Zip : 94546-5340
Country : US
Telephone Number : 510-581-1484
Fax Number : 510-581-7779
Provider Business Practice Location Address
First Line : 3031 W MARCH LN STE 310
Second Line :
City : STOCKTON
State : CA
Zip : 95219-6562
Country : US
Telephone Number : 209-472-0800
Fax Number : 209-472-1203
Authorized Official
Title or Position : CHIEF REGIONAL MEDICAL OFFICER
Name : ALEXANDER REYZELMAN
Credential : DPM
Telephone Number : 415-292-0638
Provider Enumeration Date : 07/11/2023
Last Update Date : 07/01/2024

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Directions to “BAY AREA FOOT CARE, INC ” Practice Location

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