| NPI | 1275068967 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEVERLY STEPHENS Secretary 310-671-5800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CA E2206) |
| Enumeration Date | 2017-05-01 |
| Last Update Date | 2023-01-09 |