Providence Podiatry Care, INC
NPI #1376202986 in San Bernardino, California
Provider Information
- NPI Number
- 1376202986
- Entity Type
- Organization
- Organization Name
- Providence Podiatry Care, INC
- Primary Specialty
- Podiatrist - Foot & Ankle Surgery
- Enumeration Date
- Dec 10, 2021
- Last Updated
- Jun 21, 2023
Practice Location
- Address
- 473 E CARNEGIE DRIVE
- Address 2
- SUITE 200
- City
- San Bernardino
- State
- California
- ZIP Code
- 92408
- Phone
- (909) 244-7430
Authorized Official
- Name
- EDDIE AVILA
- Title
- SECRETARY/TREASUER
- Phone
- (909) 244-7430
Specialties & Taxonomy Codes
| Specialty |
|---|
| Podiatrist - Foot & Ankle Surgery — Foot & Ankle Surgery |
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