| NPI | 1265762090 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLAS J BEVILACQUA Owner 818-902-5755 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CA E4859) |
| Enumeration Date | 2009-12-29 |
| Last Update Date | 2010-05-24 |