| NPI | 1780166074 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROZANA REYZELMAN Authorized Official 415-680-0871 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 213EP1101X Podiatrist Primary Podiatric Medicine |
| Additional Taxonomies | 213ES0103X Podiatrist Foot & Ankle Surgery |
| Enumeration Date | 2018-09-04 |
| Last Update Date | 2021-08-28 |