| NPI | 1043664857 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA CHONG Dpm 909-464-1401 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CA E4985) |
| Enumeration Date | 2016-04-18 |
| Last Update Date | 2016-04-18 |