| NPI | 1053616086 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GENNADY KOLODENKER Owner 949-651-1202 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CA E4880) |
| Enumeration Date | 2011-01-23 |
| Last Update Date | 2022-06-24 |