Provider Demographics
NPI:1619528544
Name:MOSTAGHIMI FOOT & ANKLE INC.
Entity Type:Organization
Organization Name:MOSTAGHIMI FOOT & ANKLE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BITA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSTAGHIMI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:650-464-1787
Mailing Address - Street 1:1191 W TENNYSON RD STE 3
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94544-4454
Mailing Address - Country:US
Mailing Address - Phone:510-732-1566
Mailing Address - Fax:510-732-1515
Practice Address - Street 1:1191 W TENNYSON RD STE 3
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94544-4454
Practice Address - Country:US
Practice Address - Phone:510-732-1566
Practice Address - Fax:510-732-1515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-23
Last Update Date:2019-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty