| NPI | 1700374667 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLIOT FIALKOFF CEO 818-317-4127 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist |
| Additional Taxonomies | 207N00000X Dermatology |
| 207Q00000X Family Medicine | |
| Enumeration Date | 2018-04-26 |
| Last Update Date | 2019-12-18 |