Provider Demographics
NPI:1821749615
Name:TOE-TAL FAMILY FOOTCARE
Entity Type:Organization
Organization Name:TOE-TAL FAMILY FOOTCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:G
Authorized Official - Last Name:MELENDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-889-1941
Mailing Address - Street 1:2604B EL CAMINO REAL # 311
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-1214
Mailing Address - Country:US
Mailing Address - Phone:702-956-3750
Mailing Address - Fax:702-233-8928
Practice Address - Street 1:3317 SALMON CREEK DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89129-6188
Practice Address - Country:US
Practice Address - Phone:702-956-3750
Practice Address - Fax:702-233-8928
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-12
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty