PROVIDENCE PODIATRY CARE, INC; NPI #1376202986

Contact Information

PROVIDENCE PODIATRY CARE, INC

473 E CARNEGIE DRIVE
SUITE 200
SAN BERNARDINO, CA 92408

Phone: 909-244-7430
Fax: 909-495-1380
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Surgery, Foot & Ankle	213ES0103X	48	Podiatry

Indicates primary specialty

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NPI Profile & details for PROVIDENCE PODIATRY CARE, INC

NPI Number	`1376202986`
LBN Legal business name	PROVIDENCE PODIATRY CARE, INC
Authorized official	EDDIE AVILA - (SECRETARY/TREASUER)
Entity	Organization
Organization subpart ¹	No
Enumeration date	12/10/2021
Last updated	06/21/2023 - About 3 years ago
Identifiers	n/a

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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PROVIDENCE PODIATRY CARE, INC

Contact Information

Specialty

Surgery, Foot & Ankle

NPI Profile & details for PROVIDENCE PODIATRY CARE, INC

Reviews for PROVIDENCE PODIATRY CARE, INC