Provider Demographics
NPI:1710186655
Name:BELCZYK, RONALD (DPM)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:
Last Name:BELCZYK
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19360 RINALDI ST STE 363
Mailing Address - Street 2:
Mailing Address - City:PORTER RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:91326-1607
Mailing Address - Country:US
Mailing Address - Phone:866-895-8716
Mailing Address - Fax:
Practice Address - Street 1:903 W 7TH ST
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93030-6755
Practice Address - Country:US
Practice Address - Phone:747-263-9696
Practice Address - Fax:805-263-4090
Is Sole Proprietor?:No
Enumeration Date:2007-07-11
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC005767213ES0103X
CAE4906213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX196012201Medicaid
CAE4906OtherLICENSE
CABB8865896OtherDEA
TX196012201Medicaid
TX8L11006Medicare PIN