Provider Demographics
NPI:1508954199
Name:ASSOCIATED PODIATRY GROUP OF SAN CARLOS
Entity Type:Organization
Organization Name:ASSOCIATED PODIATRY GROUP OF SAN CARLOS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CURTIS
Authorized Official - Middle Name:D
Authorized Official - Last Name:LEVIANT
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:650-593-8083
Mailing Address - Street 1:961 LAUREL ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SAN CARLOS
Mailing Address - State:CA
Mailing Address - Zip Code:94070-3949
Mailing Address - Country:US
Mailing Address - Phone:650-593-8083
Mailing Address - Fax:650-593-9145
Practice Address - Street 1:961 LAUREL ST
Practice Address - Street 2:SUITE 100
Practice Address - City:SAN CARLOS
Practice Address - State:CA
Practice Address - Zip Code:94070-3949
Practice Address - Country:US
Practice Address - Phone:650-593-8083
Practice Address - Fax:650-593-9145
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ASSOCIATED PODIATRY GROUP OF SAN CARLOS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-10
Last Update Date:2011-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies