NPI | 1164902565 |
---|---|
Entity Type | Organization |
Authorized Contact | JONATHAN MATTHEW MOSS Owner 714-404-5641 |
Organization Subpart ? | No |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery |
Additional Taxonomies | 261QP1100X Clinic/Center, Podiatric |
Enumeration Date | 2018-08-16 |
Last Update Date | 2024-04-30 |