Provider Demographics
NPI:1871075168
Name:ALEXANDER REYZELMAN, DPM, INC.
Entity type:Organization
Organization Name:ALEXANDER REYZELMAN, DPM, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DELEGATED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:ROZANA
Authorized Official - Middle Name:
Authorized Official - Last Name:REYZELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-680-0871
Mailing Address - Street 1:2299 POST ST STE 205
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-3473
Mailing Address - Country:US
Mailing Address - Phone:415-292-0638
Mailing Address - Fax:415-292-0718
Practice Address - Street 1:1 SHRADER ST STE 510
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94117-1034
Practice Address - Country:US
Practice Address - Phone:415-759-2014
Practice Address - Fax:415-759-2015
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALEXANDER REYZELMAN, DPM, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-09-04
Last Update Date:2021-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Multi-Specialty
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty