Provider Demographics
NPI:1215543400
Name:RONALD J BELCZYK, DPM INC.
Entity Type:Organization
Organization Name:RONALD J BELCZYK, DPM INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:BELCZYK
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:747-263-9696
Mailing Address - Street 1:19360 RINALDI ST STE 363
Mailing Address - Street 2:
Mailing Address - City:PORTER RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:91326-1607
Mailing Address - Country:US
Mailing Address - Phone:866-895-8716
Mailing Address - Fax:818-475-1406
Practice Address - Street 1:903 W 7TH ST
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93030-6755
Practice Address - Country:US
Practice Address - Phone:747-263-9696
Practice Address - Fax:818-475-1406
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RONALD J BELCZYK DPM INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-09-22
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty