Family Foot Care Specialist Podiatry Center
Organization Active NPI Durable Medical Equipment & Medical Supplies · Fortuna, CA
NPI 1003986779 · NPPES record last updated Jul 17, 2014
Key facts
- NPI
- 1003986779
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Durable Medical Equipment & Medical Supplies 332B00000X
- Legal business name
- FAMILY FOOT CARE SPECIALIST PODIATRY CENTER
- Practice address
- 1730 Main St
Fortuna, CA 95540-2451 - Phone
- (707) 725-5223
- Fax
- (707) 725-2756
- NPI assigned
- Nov 9, 2006
- Organization subpart
- No
Authorized official
- Name
- Neil R Kelley, DPM
- Title
- Owner
- Phone
- (707) 725-5223
Practitioners 1
-
Neil R Kelley, DPM
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | CA | Yes |
Addresses
Primary practice location
1730 Main St
Fortuna, CA 95540-2451
Mailing address
1730 Main St
Fortuna, CA 95540-2451
Phone (707) 725-5223
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699791160 01 | Medicaid | CA |
Other providers in Fortuna, CA
- Kerisa Sue Elloway
- Courtney Embry
- Gabriel Enriquez
- Dana Louise Estevo
- Katherine Anne Talbert Estlin
- Family Foot Care Specialists Podiatry Center Inc
- Neal E Feuerman
- Ana Fernanda Fierro
- Amber Ford
- Fortuna Assisted Living LLC
All providers in Fortuna, CA · Durable Medical Equipment & Medical Supplies in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 17, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.