North Bay Foot And Ankle Clinic, INC
Podiatrist, Foot & Ankle Surgery in Santa Rosa, CA. Organization (NPI-2).
NPI number1033284591
StatusActive
Last updated in NPPESNov 29, 2010
Details
- NPI
- 1033284591
- Entity type
- Organization (NPI-2)
- Legal business name
- North Bay Foot And Ankle Clinic, INC
- Organization subpart
- No
- Enumeration date
- Nov 21, 2006
- Last updated
- Nov 29, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 213ES0103X | Podiatrist, Foot & Ankle Surgery | E4562 | CA | Yes |
Other names
- Adelina B. Stateva (Doing Business As)
Practice location
1041 4th StSuite B
Santa Rosa, CA 95404-4329
Phone 707-546-2107 · Fax 707-573-0315
Mailing address
1041 4th StSuite B
Santa Rosa, CA 95404-4329
Phone 707-546-2107 · Fax 707-573-0315
Authorized official
Adelina B Stateva
Ceo
7075462107
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