Provider Demographics
NPI:1043870975
Name:OCEANSIDE FOOT & ANKLE CENTER INC.
Entity Type:Organization
Organization Name:OCEANSIDE FOOT & ANKLE CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:760-630-9200
Mailing Address - Street 1:3230 WARING CT STE M
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92056-4509
Mailing Address - Country:US
Mailing Address - Phone:760-630-9200
Mailing Address - Fax:760-630-6239
Practice Address - Street 1:3230 WARING CT STE M
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92056-4509
Practice Address - Country:US
Practice Address - Phone:760-630-9200
Practice Address - Fax:760-630-6239
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-13
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty