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Organization

NORTH BAY FOOT & ANKLE CENTER INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PETER REDKO (PRESIDENT)
(707) 769-8481
Entity
Organization

Contact information

Practice address
1400 PROFESSIONAL DR, # 102, PETALUMA, CA 94954
(707) 769-8481
(707) 769-0751
Mailing address
1400 PROFESSIONAL DR, # 102, PETALUMA, CA 94954
(707) 769-8481
(707) 769-0751

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
E1458
CA
213E00000X
Podiatrist
Primary
E4517
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
ZZZ26258Z
CA
Enumeration date
08/30/2006
Last updated
05/08/2013
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