Organization
BAY AREA FOOT AND ANKLE SPECIALISTS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SALLY T PHAM DPM (PRESIDENT)
(925) 455-1555
Entity
Organization
Contact information
Practice address
48 FENTON ST, LIVERMORE, CA 94550-4144
(925) 455-1555
(925) 292-7592
Mailing address
48 FENTON ST, LIVERMORE, CA 94550-4144
(925) 455-1555
(925) 292-7592
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
E4685
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
FJ032A
MEDICARE PTAN
CA
Enumeration date
02/17/2011
Last updated
01/07/2015
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