| NPI | 1710425921 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH PASSERI Owner 925-829-4641 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist |
| Additional Taxonomies | 261QP1100X Clinic/Center, Podiatric |
| Enumeration Date | 2017-02-08 |
| Last Update Date | 2023-01-31 |