Provider Demographics
NPI:1184770331
Name:CAMARDA FOOT CLINIC, INC.
Entity type:Organization
Organization Name:CAMARDA FOOT CLINIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:CAMARDA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:925-820-7492
Mailing Address - Street 1:43 PULIDO CT
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94526-1623
Mailing Address - Country:US
Mailing Address - Phone:925-820-7492
Mailing Address - Fax:925-820-9022
Practice Address - Street 1:43 PULIDO CT
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:CA
Practice Address - Zip Code:94526-1623
Practice Address - Country:US
Practice Address - Phone:925-820-7492
Practice Address - Fax:925-820-9022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-27
Last Update Date:2009-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE26770213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ029087Medicare ID - Type UnspecifiedPROVIDER NUMBER
CAAZ285Medicare PIN
CAAS984ZMedicare PIN
CAZZZ029112Medicare ID - Type UnspecifiedPROVIDER NUMBER
CAZZZ029102Medicare ID - Type UnspecifiedPROVIDER NUMBER
CAZZZ029092Medicare ID - Type UnspecifiedPROVIDER NUMBER