Provider Demographics
NPI:1144643289
Name:CALIFORNIA FOOT AND ANKLE GROUP, INC.
Entity type:Organization
Organization Name:CALIFORNIA FOOT AND ANKLE GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SAVASKY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:248-808-9072
Mailing Address - Street 1:13420 NEWPORT AVE STE E
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-3745
Mailing Address - Country:US
Mailing Address - Phone:714-352-5550
Mailing Address - Fax:714-352-5599
Practice Address - Street 1:13420 NEWPORT AVE STE E
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-3745
Practice Address - Country:US
Practice Address - Phone:714-352-5550
Practice Address - Fax:714-352-5599
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-24
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Multi-Specialty
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE4530OtherLICENSE