| NPI | 1134941883 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIO COLUNGA REYES Chief Executive Officer 310-517-4736 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| Enumeration Date | 2024-10-24 |
| Last Update Date | 2024-10-24 |