| NPI | 1558879924 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON KHADAVI President 818-642-3660 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP1100X Clinic/Center, Podiatric (Licence: CA E5064) |
| Enumeration Date | 2018-01-18 |
| Last Update Date | 2020-10-01 |