Provider Demographics
NPI:1801633680
Name:BAY AREA FOOT CARE INC
Entity type:Organization
Organization Name:BAY AREA FOOT CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF REGIONAL MEDICAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:REYZELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:415-292-0638
Mailing Address - Street 1:PO BOX 25576
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-2006
Mailing Address - Country:US
Mailing Address - Phone:415-645-4525
Mailing Address - Fax:
Practice Address - Street 1:3000 COLBY ST STE 107
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705-2090
Practice Address - Country:US
Practice Address - Phone:510-848-7977
Practice Address - Fax:510-848-1678
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BAY AREA FOOT CARE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-07-10
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty