| 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 |