Provider Demographics
NPI:1144948118
Name:BAY AREA FOOT CARE, INC
Entity type:Organization
Organization Name:BAY AREA FOOT CARE, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CRMO
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:REYZELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-292-0638
Mailing Address - Street 1:20130 LAKE CHABOT RD STE 202
Mailing Address - Street 2:
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94546-5340
Mailing Address - Country:US
Mailing Address - Phone:510-581-1484
Mailing Address - Fax:510-581-7779
Practice Address - Street 1:9029 SOQUEL AVE STE D
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95062-2085
Practice Address - Country:US
Practice Address - Phone:831-475-7900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BAY AREA FOOT CARE, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-08-16
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty