| NPI | 1255478129 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW M DO Doctor Of Podiatric Medicine 949-645-3338 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: CA E3881) |
| Additional Taxonomies | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: CA E3881) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CA E3881) | |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2007-11-15 |