Providence Podiatry Care, Inc.

LBN: Providence Podiatry Care, Inc.
Providence Podiatry Care, Inc. is an health care organization with primary practice located at 10621 Church St Ste 120 , Rancho Cucamonga CA 91730-6834. The organization recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, which is considered as the primary health care specialty. Providence Podiatry Care, Inc. can be contacted via phone (909) 944-0481, or through Avila, Eddie via phone (909) 944-0486.

Contact Information

Primary practice address
10621 Church St Ste 120 Rancho Cucamonga CA 91730-6834
Phone: (909) 944-0481
Fax: (909) 944-3161
Website:
Map and Directions
Authorized official contact:
Name: Avila, Eddie
Phone: (909) 944-0486

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X

Profile Details

NPI number 1033881735
LBN Legal business name Providence Podiatry Care, Inc.
DBA Doing business as
Authorized official Avila, Eddie
Entity Organization
Organization subpart 1 No
Enumeration date Sep 30th, 2021
Last updated Oct 4th, 2021 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033881735 NPPES
California MEDICAID 1831127349
California Other 1831127349

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