NPIMap

Organization Active NPI

Socal Foot Care PC

  • Foot & Ankle Surgery Podiatrist
  • San Diego, CA
National Provider Identifier
1972330280
Registry record updated Sep 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
SOCAL FOOT CARE PC
Practice address
3424 1St Ave
San Diego, CA 92103-4802
Phone
(619) 295-9494
Fax
(619) 295-9714
NPI assigned
Sep 19, 2024
Organization subpart
Yes
Parent organization
SOCAL FOOT CARE PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 19, 2024

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

Authorized official

Name
Alexander Reyzelman, DPM
Title
Rcmo
Phone
(415) 292-0638

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

3424 1St Ave
San Diego, CA 92103-4802

Mailing address

3424 1St Ave
San Diego, CA 92103-4802
Phone (619) 295-9494

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241115000622 CA DME Supplier - Physician - Podiatry 5395110076 Practice locations: San Diego, CA

Other NPIs with the same Medicare PAC ID 8

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Socal Foot Care PC10 organizations share this tax ID, including this one
Part of
Socal Foot Care PC

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1726704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726704000000",
    "number": "1972330280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3424 1ST AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921034802",
            "telephone_number": "619-295-9494",
            "fax_number": "619-295-9714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3424 1ST AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921034802",
            "telephone_number": "619-295-9494",
            "fax_number": "619-295-9714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOCAL FOOT CARE PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOCAL FOOT CARE PC",
        "enumeration_date": "2024-09-19",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A",
        "authorized_official_last_name": "REYZELMAN",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_title_or_position": "RCMO",
        "authorized_official_telephone_number": "415-292-0638",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.