1. Home
  2. Directory
  3. California
  4. Rancho Cucamonga
  5. Podiatrist
  6. NPI Profile

PROVIDENCE PODIATRY CARE, INC.
NPI 1033881735
Podiatrist - Foot & Ankle Surgery in Rancho Cucamonga, CA

Active since September 30, 2021
10621 CHURCH ST STE 120, RANCHO CUCAMONGA, CA 91730(909) 944-0481(909) 944-3161 Get Directions Write a Review

NPPES record last updated: October 4, 2021. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Oct 4, 2021, Sep 30, 2021 (2 updates tracked since 2021).

About Providence Podiatry Care, Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PROVIDENCE PODIATRY CARE, INC. (NPI 1033881735), doing business as Providence Podiaty Care, Inc, is a healthcare organization registered as a foot & ankle surgery in Rancho Cucamonga, California and active in the NPI registry since September 2021. The organization lists Eddie Avila, Owner/administrator, as its authorized official.

NPPES Registry Identity

NPI1033881735
Entity TypeOrganization
Primary Taxonomy213ES0103X
Legal Business NamePROVIDENCE PODIATRY CARE, INC.
Location Address10621 CHURCH ST STE 120Rancho Cucamonga, CA 91730-6834
Mailing Address10621 Church St Ste 120Rancho Cucamonga, CA 91730-6834 · (909) 944-0481 · Fax (909) 944-3161
Phone(909) 944-0481
Fax(909) 944-3161
Organization SubpartNo
Authorized OfficialEddie AvilaOwner/administrator · (909) 944-0486
Enumeration DateSeptember 30, 2021
Last NPPES UpdateOctober 4, 20212 updates tracked since enumeration
NPPES CertifiedOctober 4, 2021
✔ NPI 1033881735 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPodiatrist · Foot & Ankle SurgeryPodiatric Medicine & Surgery Service Providers
Taxonomy Code213ES0103X
10621 CHURCH ST STE 120, Rancho Cucamonga, CA 91730
Open in Google Maps ↗

Other Names 1

Doing Business AsProvidence Podiaty Care, Inc

Other Identifiers 2

Other1831127349CA · Molina Medical Group
Medicaid1831127349CA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. PETER PAUL MUTYA BADUA
Nurse Practitioner (Family)
10621 CHURCH ST STE 120
RANCHO CUCAMONGA, CA 91730
San Bernardino County (909) 944-0486
MATTHEW TAIWO ABIOLA OGBEIDE MD
Surgery
10621 CHURCH ST STE 120
RANCHO CUCAMONGA, CA 91730
San Bernardino County (909) 944-0486

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Providence Podiatry Care, Inc.'s NPI number?

The NPI number for Providence Podiatry Care, Inc. is 1033881735. It was assigned to this organization in the NPPES registry on September 30, 2021. The provider is doing business as Providence Podiaty Care, Inc.

Where is Providence Podiatry Care, Inc. located?

Providence Podiatry Care, Inc. is located at 10621 Church St Ste 120, Rancho Cucamonga, CA 91730. The listed phone number is (909) 944-0481.

What is Providence Podiatry Care, Inc.'s specialty?

The primary specialty registered for this NPI is Podiatrist, specializing in Foot & Ankle Surgery, with taxonomy code 213ES0103X.

When was this NPI record last updated?

The NPPES record for Providence Podiatry Care, Inc. was last updated on October 4, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.