| NPI | 1033959127 |
|---|---|
| Former Legal Business Name | HEALING EDGE MEDICAL GROUP -IL, LTD. |
| Entity Type | Organization |
| Authorized Contact | JEFFREY HALPERIN COO 626-673-5605 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| Enumeration Date | 2024-05-28 |
| Last Update Date | 2024-08-26 |