Provider Demographics
NPI:1528480647
Name:ALLCARE FOOT & ANKLE CENTER LLC
Entity type:Organization
Organization Name:ALLCARE FOOT & ANKLE CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:KAVEH
Authorized Official - Middle Name:
Authorized Official - Last Name:SOLTANI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:301-706-5256
Mailing Address - Street 1:313 PARK AVE
Mailing Address - Street 2:SUITE #308
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22046-3327
Mailing Address - Country:US
Mailing Address - Phone:703-462-8145
Mailing Address - Fax:703-462-9025
Practice Address - Street 1:313 PARK AVE
Practice Address - Street 2:SUITE #308
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22046-3327
Practice Address - Country:US
Practice Address - Phone:703-462-8145
Practice Address - Fax:703-462-9025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-08
Last Update Date:2014-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPO1000010213EP1101X
VA0103300864213ES0103X, 213E00000X
MD01354213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty