Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
PROVIDENCE PODIATRY CARE, INC.
Active
Organization
PROVIDENCE PODIATRY CARE, INC.
Active
Other names
Providence Podiaty Care, Inc
Organization subpart
No
Provider details
NPI number
Authorized official
EDDIE AVILA (OWNER/ADMINISTRATOR)
(909) 944-0486
Entity
Organization
Contact information
Practice address
10621 CHURCH ST STE 120, RANCHO CUCAMONGA, CA 91730-6834
(909) 944-0481
(909) 944-3161
Mailing address
10621 CHURCH ST STE 120, RANCHO CUCAMONGA, CA 91730-6834
(909) 944-0481
(909) 944-3161
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
NULL
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Enumeration date
09/30/2021
Last updated
10/04/2021
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign upProduct
Developers