Provider Demographics
NPI:1821780461
Name:VALLEY FOOT AND ANKLE SPECIALTY PROVIDERS, INC.
Entity Type:Organization
Organization Name:VALLEY FOOT AND ANKLE SPECIALTY PROVIDERS, INC.
Other - Org Name:VALLEY PODIATRIC WOUND CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:OJI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:559-436-4820
Mailing Address - Street 1:6145 N THESTA ST
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-5266
Mailing Address - Country:US
Mailing Address - Phone:559-436-4820
Mailing Address - Fax:559-436-4821
Practice Address - Street 1:6145 N THESTA ST
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-5266
Practice Address - Country:US
Practice Address - Phone:559-436-4820
Practice Address - Fax:559-436-4821
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-23
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty