Organization
PROVIDENCE PODIATRY CARE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDDIE AVILA (SECRETARY/TREASUER)
(909) 244-7430
Entity
Organization
Contact information
Practice address
473 E CARNEGIE DRIVE, SUITE 200, SAN BERNARDINO, CA 92408
(909) 244-7430
(909) 495-1380
Mailing address
473 E CARNEGIE DRIVE, SUITE 200, SAN BERNARDINO, CA 92408
(909) 244-7430
(909) 495-1380
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Enumeration date
12/10/2021
Last updated
06/21/2023
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