Provider Demographics
NPI:1164460663
Name:CAPITAL FOOT & ANKLE, A PODIATRY CORPORATION
Entity Type:Organization
Organization Name:CAPITAL FOOT & ANKLE, A PODIATRY CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:ISABEL
Authorized Official - Last Name:DOCHARTY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:916-453-8900
Mailing Address - Street 1:3800 J ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-5551
Mailing Address - Country:US
Mailing Address - Phone:916-453-8900
Mailing Address - Fax:916-454-4359
Practice Address - Street 1:3800 J ST
Practice Address - Street 2:SUITE 200
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-5551
Practice Address - Country:US
Practice Address - Phone:916-453-8900
Practice Address - Fax:916-454-4359
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2016-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADG7572OtherRR GROUP PROVIDER #
CAT11201Medicare UPIN
CADG7572OtherRR GROUP PROVIDER #
CAZZZ05305ZMedicare PIN