North Bay Foot and Ankle Clinic, Inc

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

E4562 Issued in CA

Legal business name

NORTH BAY FOOT AND ANKLE CLINIC, INC

Practice address

1041 4TH St
Suite B
Santa Rosa, CA 95404-4329

Phone

(707) 546-2107

Fax

(707) 573-0315

NPI assigned

Nov 21, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Adelina B Stateva, DPM

Title

Ceo

Phone

(707) 546-2107

Specialties & licenses 1

Addresses

Other names 1

• Adelina B. Stateva Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290988800000",
    "number": "1033284591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1041 4TH ST",
            "address_2": "SUITE B",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044329",
            "telephone_number": "707-546-2107",
            "fax_number": "707-573-0315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1041 4TH ST",
            "address_2": "SUITE B",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044329",
            "telephone_number": "707-546-2107",
            "fax_number": "707-573-0315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH BAY FOOT AND ANKLE CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-21",
        "last_updated": "2010-11-29",
        "status": "A",
        "authorized_official_last_name": "STATEVA",
        "authorized_official_first_name": "ADELINA",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "707-546-2107",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E4562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Adelina B. Stateva",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Foot & Ankle Surgery Podiatrist in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Foot & Ankle Surgery Podiatrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.