Organization
ADVANCED FOOT CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD CHARLES LAVIGNA DPM (OWNER)
(510) 463-3888
Entity
Organization
Contact information
Practice address
2844 SUMMIT ST STE 107, OAKLAND, CA 94609-3641
(510) 463-3888
(510) 433-0130
Mailing address
2844 SUMMIT ST STE 107, OAKLAND, CA 94609-3641
(510) 463-3888
(510) 433-0130
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
E3779
CA
Other
Enumeration date
05/09/2014
Last updated
09/15/2015
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