| NPI | 1073393260 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANE H COX Credentialing Specialist 949-664-2796 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery |
| Additional Taxonomies | 213E00000X Podiatrist |
| Enumeration Date | 2023-10-04 |
| Last Update Date | 2024-03-13 |