| NPI | 1720428626 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACI BOGIN Podiatrist/Owner 323-481-7597 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: CO pod-698) |
| Enumeration Date | 2013-06-25 |
| Last Update Date | 2013-11-21 |