MEDICARE: TOES ON THE GO 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
1	213E00000X	Podiatrist	E3521	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	AU219Z	OTHER	CA	MEDICARE PTAN- INDIVIDUAL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1124120654	OTHER	CA	GROUP NPI
3	1861499782	OTHER	CA	INDIVIDUAL NPI

General Provider Information

NPI Number	:	1124120654
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOES ON THE GO INC

Provider Business Mailing Address
First Line	:	26615 CARMEL CENTER PL STE 103
Second Line	:
City	:	CARMEL
State	:	CA
Zip	:	93923-8654
Country	:	US
Telephone Number	:	831-425-8637
Fax Number	:	831-425-8634

Provider Business Practice Location Address
First Line	:	26615 CARMEL CENTER PL STE 103
Second Line	:
City	:	CARMEL
State	:	CA
Zip	:	93923-8654
Country	:	US
Telephone Number	:	931-373-8637
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MICHELE MARIA KRAFT
Credential	:	DPM
Telephone Number	:	831-425-8637

Provider Enumeration Date	:	09/04/2006
Last Update Date	:	12/10/2018

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Directions to “TOES ON THE GO INC ” Practice Location

Language	Start Address	Practice Location

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