Provider Demographics
NPI:1518186121
Name:PODIATRIC PHYSICIANS MANAGEMENT
Entity Type:Organization
Organization Name:PODIATRIC PHYSICIANS MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:REISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-834-8804
Mailing Address - Street 1:1620 S STAPLEY DR
Mailing Address - Street 2:STE 132
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85204-6634
Mailing Address - Country:US
Mailing Address - Phone:480-834-8804
Mailing Address - Fax:
Practice Address - Street 1:1620 S STAPLEY DR
Practice Address - Street 2:STE 132
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85204-6634
Practice Address - Country:US
Practice Address - Phone:480-834-8804
Practice Address - Fax:480-464-8287
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty