Provider Demographics
NPI:1467509661
Name:CITY STATIONS INC
Entity Type:Organization
Organization Name:CITY STATIONS INC
Other - Org Name:FOOT SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-389-3383
Mailing Address - Street 1:2370 LAS POSAS RD STE C
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-3444
Mailing Address - Country:US
Mailing Address - Phone:805-389-3383
Mailing Address - Fax:805-389-3533
Practice Address - Street 1:2370 LAS POSAS RD STE C
Practice Address - Street 2:
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-3444
Practice Address - Country:US
Practice Address - Phone:805-389-3383
Practice Address - Fax:805-389-3533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5548310001Medicare ID - Type UnspecifiedBILLING NUMBER