| NPI | 1003168626 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER CHANG KIM President 949-379-3080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: CA E4027) |
| Additional Taxonomies | 261QP1100X Clinic/Center Podiatric |
| Enumeration Date | 2012-10-05 |
| Last Update Date | 2023-10-03 |