| NPI | 1689850638 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DALE SHRUM CEO 760-674-3355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: CA E-3589) |
| Additional Taxonomies | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: CA E3589) |
| Enumeration Date | 2008-01-21 |
| Last Update Date | 2013-05-06 |