1609940154 NPI number — FOOT AND ANKLE INSTITUTE

Table of content: (NPI 1609940154)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609940154 NPI number — FOOT AND ANKLE INSTITUTE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FOOT AND ANKLE INSTITUTE
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1609940154
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/06/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9300 STOCKDALE HIGHWAY
Provider Second Line Business Mailing Address:
SUITE 440
Provider Business Mailing Address City Name:
BAKERSFIELD
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93311
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
661-663-8483
Provider Business Mailing Address Fax Number:
661-663-3095

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
840 TUCKER ROAD
Provider Second Line Business Practice Location Address:
SUITE G
Provider Business Practice Location Address City Name:
TEHACHAPI
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93561
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-822-5537
Provider Business Practice Location Address Fax Number:
661-822-4307
Provider Enumeration Date:
11/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ZIMMERMAN
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
C
Authorized Official Title or Position:
MANAGING PARTNER
Authorized Official Telephone Number:
661-663-8483

Provider Taxonomy Codes

  • Taxonomy code: 213ES0103X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: CH7243 . This is a "RR MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: ZZZ60037Z . This is a "BLUE SHIELD" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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