Provider Demographics
NPI:1659903722
Name:BAY AREA FOOT CARE, INC
Entity Type:Organization
Organization Name:BAY AREA FOOT CARE, INC
Other - Org Name:BAY AREA FOOT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JULIE-ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:CARPENTIERI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-399-0221
Mailing Address - Street 1:20130 LAKE CHABOT RD STE 202
Mailing Address - Street 2:
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94546-5340
Mailing Address - Country:US
Mailing Address - Phone:510-581-1484
Mailing Address - Fax:
Practice Address - Street 1:5924 STONERIDGE DR STE 102
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-2750
Practice Address - Country:US
Practice Address - Phone:510-581-1484
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BAY AREA FOOT CARE, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-02-06
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6186880005OtherDME