Provider Demographics
NPI:1891115838
Name:NAPA VALLEY FOOT & ANKLE, INC
Entity Type:Organization
Organization Name:NAPA VALLEY FOOT & ANKLE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:925-207-2951
Mailing Address - Street 1:423 MCKENNA CT
Mailing Address - Street 2:
Mailing Address - City:BENICIA
Mailing Address - State:CA
Mailing Address - Zip Code:94510-3979
Mailing Address - Country:US
Mailing Address - Phone:925-207-2876
Mailing Address - Fax:
Practice Address - Street 1:1001 NUT TREE RD
Practice Address - Street 2:SUITE 220
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95687-4166
Practice Address - Country:US
Practice Address - Phone:707-448-8469
Practice Address - Fax:707-448-7653
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-17
Last Update Date:2014-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4801213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty