Provider Demographics
NPI:1497307227
Name:BAY AREA FOOT AND ANKLE CARE INC
Entity Type:Organization
Organization Name:BAY AREA FOOT AND ANKLE CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:EA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:215-805-8166
Mailing Address - Street 1:13847 E 14TH ST STE 203
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94578-2626
Mailing Address - Country:US
Mailing Address - Phone:510-483-3390
Mailing Address - Fax:510-394-6402
Practice Address - Street 1:1300 BANCROFT AVE STE 103
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94577-5147
Practice Address - Country:US
Practice Address - Phone:215-805-8166
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-11
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty