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ALI DEYHIM DPM

Foot & Ankle Surgery >> Podiatrist >> Podiatric Medicine & Surgery Service Providers

Registrant NPI Number: 1851590012

Individual Registrant:
 ALI  DEYHIM DPM
Gender: M
Not Sole Proprietor

Location and contact information for practice:
1730 MAIN ST  FORTUNA, CA 95540 US
Tel: 707-725-5223  Fax: --

Contact information for business:
1730 MAIN ST  FORTUNA, CA 95540-2467 US
Tel: --  Fax: --

Registration Information:
NPI: 1851590012
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y213ES0103XPodiatric Medicine & Surgery Service Providers
Podiatrist
Foot & Ankle Surgery
CA5520

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
ANTHEMANTHEM01




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