Provider Demographics
NPI:1275244659
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:REGIONAL CHIEF 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:510-399-1364
Practice Address - Street 1:6600 MERCY CT STE 260
Practice Address - Street 2:
Practice Address - City:FAIR OAKS
Practice Address - State:CA
Practice Address - Zip Code:95628-3190
Practice Address - Country:US
Practice Address - Phone:916-961-3434
Practice Address - Fax:916-844-0285
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BAY AREA FOOT CARE, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-12-07
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6186880020OtherDME