Provider Demographics
NPI:1902935091
Name:VALLEY FOOT AND ANKLE, INC.
Entity Type:Organization
Organization Name:VALLEY FOOT AND ANKLE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:BURATTI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:818-907-6102
Mailing Address - Street 1:5400 BALBOA BLVD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-1502
Mailing Address - Country:US
Mailing Address - Phone:818-907-6102
Mailing Address - Fax:866-513-4995
Practice Address - Street 1:5400 BALBOA BLVD
Practice Address - Street 2:SUITE 120
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-1502
Practice Address - Country:US
Practice Address - Phone:818-907-6102
Practice Address - Fax:866-513-4995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2009-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5418870001OtherDMERC SUPPLIER NUMBER
CA5418870001Medicare NSC