Provider Demographics
NPI:1104610377
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:RCMO
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:REYZELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
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:510-399-1364
Practice Address - Street 1:380 DIABLO RD STE 201
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:CA
Practice Address - Zip Code:94526-3410
Practice Address - Country:US
Practice Address - Phone:925-381-1898
Practice Address - Fax:925-831-4910
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BAY AREA FOOT CARE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-04-04
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty