Provider Demographics
NPI:1003824319
Name:DAVIS FOOT COMFORT CENTER, INC.
Entity Type:Organization
Organization Name:DAVIS FOOT COMFORT CENTER, INC.
Other - Org Name:DAVIS SHOE THERAPEUTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ARNOLD
Authorized Official - Middle Name:S
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:CPED
Authorized Official - Phone:415-661-8705
Mailing Address - Street 1:3921 JUDAH ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94122-1120
Mailing Address - Country:US
Mailing Address - Phone:415-661-8705
Mailing Address - Fax:415-661-4507
Practice Address - Street 1:3921 JUDAH ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94122-1120
Practice Address - Country:US
Practice Address - Phone:415-661-8705
Practice Address - Fax:415-661-4507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0343090001Medicare ID - Type Unspecified