| North Bay Foot & Ankle Center Inc | |
|
1400 Professional Dr, # 102, Petaluma, CA 94954 | |
| (707) 769-8481 | |
| (707) 769-0751 |
| Full Name | North Bay Foot & Ankle Center Inc |
|---|---|
| Type | Facility |
| Speciality | Podiatrist |
| Location | 1400 Professional Dr, Petaluma, California |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912017021 | NPI | - | NPPES |
| ZZZ26258Z | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 213E00000X | Podiatrist | E1458 (California) | Secondary |
| 213E00000X | Podiatrist | E4517 (California) | Primary |
| Provider Name | Peter Redko |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1750456687 PECOS PAC ID: 0648262303 Enrollment ID: I20040401000851 |
| Provider Name | Rochelle L Bomar |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1558433029 PECOS PAC ID: 9830356310 Enrollment ID: I20120210000758 |
| Provider Name | Amrita Kaur |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1215383088 PECOS PAC ID: 4880921030 Enrollment ID: I20190809001786 |
| Provider Name | Keyvan Ganz |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1538104096 PECOS PAC ID: 1557379849 Enrollment ID: I20210312002168 |
| Mailing Address | Practice Location Address |
|---|---|
| North Bay Foot & Ankle Center Inc 1400 Professional Dr, # 102, Petaluma, CA 94954 Ph: (707) 769-8481 | North Bay Foot & Ankle Center Inc 1400 Professional Dr, # 102, Petaluma, CA 94954 Ph: (707) 769-8481 |
Dr. Ronald M Lavigna, DPM Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 1400 Professional Drive, Suite 102, Petaluma, CA 94954 Phone: 707-769-8481 Fax: 707-769-0751 | |
Dr. Michael Alan Johnson, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 108 Lynch Creek Way, Suite 3, Petaluma, CA 94954 Phone: 707-763-2253 Fax: 707-763-7030 | |
Mrs. Rochelle Lenore Bomar, D.P.M. Podiatrist Medicare: Medicare Enrolled Practice Location: 231 N Mcdowell Blvd, Suite D, Petaluma, CA 94954 Phone: 707-763-4343 Fax: 707-283-4663 | |
Don Markley Griffith, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 108 Lynch Creek Wy, #3, Petaluma, CA 94954 Phone: 707-763-2253 Fax: 707-763-7030 | |
Dr. Peter Redko, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 1400 Professional Drive, Suite 102, Petaluma, CA 94954 Phone: 707-769-8481 Fax: 707-769-0751 | |
St Joseph Heritage Healthcare Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 108 Lynch Creek Way, Suite 3, Petaluma, CA 94954 Phone: 707-763-7403 Fax: 707-789-0900 |