Provider Demographics
NPI:1679641716
Name:FOOT AND ANKLE INSTITUTE
Entity Type:Organization
Organization Name:FOOT AND ANKLE INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:C
Authorized Official - Last Name:ZIMMERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:661-663-8483
Mailing Address - Street 1:9300 STOCKDALE HIGHWAY
Mailing Address - Street 2:SUITE 400
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311
Mailing Address - Country:US
Mailing Address - Phone:661-663-8483
Mailing Address - Fax:661-663-3095
Practice Address - Street 1:9300 STOCKDALE HWY
Practice Address - Street 2:SUITE 400
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311-3613
Practice Address - Country:US
Practice Address - Phone:661-663-8483
Practice Address - Fax:661-663-3095
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FOOT AND ANKLE INSTITUTE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-30
Last Update Date:2015-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ60036ZOtherBLUE SHIELD
CA4355390001OtherREGION D DMERC
CH7243OtherRR MEDICARE
CAZZZ17974ZMedicare UPIN