Dr. Keyvan Ganz
Podiatrist Sports Medicine
1400 Professional Dr Ste 102
Petaluma
, California 94954-5110
Dr. Keyvan Ganz
Podiatrist Sports Medicine
1400 Professional Dr Ste 102
Petaluma
, California 94954-5110
(707) 769-8481
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About
Features
Specialties
- Podiatrist
- Sports Medicine
Languages spoken
- English
Location
First Address
- Dr. Keyvan Ganz
- 1400 Professional Dr Ste 102
- Petaluma, CA
- Zip : 94954-5110
- Phone : (707) 769-8481
Second Address
- Dr. Keyvan Ganz
- 1400 Professional Dr Ste 102
- Petaluma, CA
- Zip : 94954-5110
- Phone : (707) 769-8481
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What type of doctor is Dr. Keyvan Ganz
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Is Dr. Keyvan Ganz a sole practitioner?
Is Dr. Keyvan Ganz accepting new patients?
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Does Dr. Keyvan Ganz offers telemedicine?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 213E00000X | Podiatrist | 0167 | AZ |
| N | 222Z00000X | Podiatrist | 0167 | AZ |
| N | 213E00000X | Podiatrist | 1779 | TX |
| N | 222Z00000X | Podiatrist | 1779 | TX |
| N | 213E00000X | Podiatrist | 901365 | FL |
| N | 222Z00000X | Podiatrist | 901365 | FL |
| Y | 2081S0010X | Sports Medicine | E5728 | CA |
| Y | 213ES0000X | Sports Medicine | E5728 | CA |
National Provider Identifier
| NPI | 1538104096 |
|---|---|
| Provider Name | Dr. Keyvan Ganz |
| First Address | Petaluma, CA 94954-5110 |
| Second Address | Petaluma, CA 94954-5110 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 18/06/2006 |
| Last Update Date | 12/04/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| V08735 | (02) | TX |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.