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NPI Code Detail

MEDICARE: ARTISAN FOOT AND ANKLE PODIATRIC SPECIALISTS INC

MEDICARE: ARTISAN FOOT AND ANKLE PODIATRIC SPECIALISTS 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
1213E00000XPodiatrist
2332B00000XDurable Medical Equipment & Medical Supplies
3213ES0103XFoot & Ankle Surgery Podiatrist

General Provider Information

NPI Number : 1174354435
Entity Type Code : Organization
Provider Name (Legal Business Name) : ARTISAN FOOT AND ANKLE PODIATRIC SPECIALISTS INC
Provider Business Mailing Address
First Line : PO BOX 843263
Second Line :
City : LOS ANGELES
State : CA
Zip : 90084-3263
Country : US
Telephone Number : 847-627-4920
Fax Number : 224-220-9743
Provider Business Practice Location Address
First Line : 319 E PALM DR STE B
Second Line :
City : PLACENTIA
State : CA
Zip : 92870-3238
Country : US
Telephone Number : 949-272-0007
Fax Number : 949-272-0006
Authorized Official
Title or Position : CMO
Name : ALEXANDER REYZELMAN
Credential : DPM
Telephone Number : 415-292-0638
Provider Enumeration Date : 08/09/2024
Last Update Date : 01/27/2026

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Directions to “ARTISAN FOOT AND ANKLE PODIATRIC SPECIALISTS INC ” Practice Location

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