Provider Demographics
NPI:1497939474
Name:BONSALL'S SHOES INC
Entity Type:Organization
Organization Name:BONSALL'S SHOES INC
Other - Org Name:FOOT SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:BONSALL
Authorized Official - Suffix:
Authorized Official - Credentials:PEDORTHIST
Authorized Official - Phone:408-376-0497
Mailing Address - Street 1:4701 HAMILTON AVE STE 701
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95130-1789
Mailing Address - Country:US
Mailing Address - Phone:408-376-0495
Mailing Address - Fax:
Practice Address - Street 1:805 E EL CAMINO REAL STE C
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-2811
Practice Address - Country:US
Practice Address - Phone:650-473-9067
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BONSALL SHOE CORP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-12-26
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies