Organization
CRISMALI PODIATRIC MEDICAL CORPORATION
Active
Other names
Step Forward Foot and Ankle
Organization subpart
No
Provider details
NPI number
Authorized official
PETER AWAD DPM (CEO)
(760) 948-7400
Entity
Organization
Contact information
Practice address
18151 BEAR VALLEY RD, HESPERIA, CA 92345-4907
(760) 948-7400
(760) 948-7866
Mailing address
18151 BEAR VALLEY RD, HESPERIA, CA 92345-4907
(760) 948-7400
(760) 948-7866
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
E3433
CA
213ES0103X
Foot & Ankle Surgery Podiatrist
E3433
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ66078Z
BLUE SHIELD
—
Enumeration date
09/06/2006
Last updated
05/02/2025
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