# PENINSULA FOOT & ANKLE CENTER CORP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346646197
- **Authorized official:** ALIREZA GHAMGOSAR DPM (PRESIDENT/PHYSICIAN)
- **Authorized official phone:** (415) 205-1127

## Contact information

- **Practice address:** 120 SAINT MATTHEWS AVE, SAN MATEO, CA 94401-3087
- **Practice address phone:** (650) 242-1689
- **Practice address fax:** (650) 477-2169
- **Mailing address:** 25 SEVILLE WAY, SAN MATEO, CA 94402-2830
- **Mailing address phone:** (415) 205-1127

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | CA | Yes |

## Other

- **Enumeration date:** 11/06/2014
- **Last updated:** 08/19/2024