Provider Demographics
NPI:1376315465
Name:FEET 1ST PODIATRY
Entity Type:Organization
Organization Name:FEET 1ST PODIATRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:REZA
Authorized Official - Last Name:AHMADINIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-382-4939
Mailing Address - Street 1:10807 LAUREL ST STE 220
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-0633
Mailing Address - Country:US
Mailing Address - Phone:909-527-3585
Mailing Address - Fax:909-527-3627
Practice Address - Street 1:10807 LAUREL ST STE 220
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-0633
Practice Address - Country:US
Practice Address - Phone:909-527-3585
Practice Address - Fax:909-527-3627
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-23
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle SurgeryGroup - Single Specialty