Provider Demographics
NPI:1710425921
Name:COMPREHENSIVE FOOT AND ANKLE CARE INC
Entity Type:Organization
Organization Name:COMPREHENSIVE FOOT AND ANKLE CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:PASSERI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:925-829-4641
Mailing Address - Street 1:2483 PADDOCK DR STE 204
Mailing Address - Street 2:
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-2428
Mailing Address - Country:US
Mailing Address - Phone:925-829-4641
Mailing Address - Fax:925-905-8971
Practice Address - Street 1:2483 PADDOCK DR
Practice Address - Street 2:
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-2428
Practice Address - Country:US
Practice Address - Phone:925-829-4641
Practice Address - Fax:925-905-8971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-08
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
No261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatricGroup - Multi-Specialty