| NPI | 1508914235 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL ALAN MATTES President Owner Practitoner 818-789-3668 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: CA e3418) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2020-11-13 |