Provider Demographics
NPI:1720136021
Name:HAYWARD FOOT AND ANKLE
Entity Type:Organization
Organization Name:HAYWARD FOOT AND ANKLE
Other - Org Name:BITA MOSTAGHIMI MD
Other - Org Type:Other Name
Authorized Official - Title/Position:BILLING SUPER
Authorized Official - Prefix:
Authorized Official - First Name:RITA
Authorized Official - Middle Name:
Authorized Official - Last Name:NYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-783-1181
Mailing Address - Street 1:1191 W TENNYSON RD
Mailing Address - Street 2:NO 3
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94544-4454
Mailing Address - Country:US
Mailing Address - Phone:510-732-1566
Mailing Address - Fax:510-732-1515
Practice Address - Street 1:1191 W TENNYSON RD
Practice Address - Street 2:NO 3
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94544-4454
Practice Address - Country:US
Practice Address - Phone:510-732-1566
Practice Address - Fax:510-732-1515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty