| NPI | 1760998736 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALBERT KIM Owner 909-500-3007 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery |
| Additional Taxonomies | 213E00000X Podiatrist |
| 213EP0504X Podiatrist Public Medicine | |
| 213EP1101X Podiatrist Primary Podiatric Medicine | |
| 213ES0000X Podiatrist Sports Medicine | |
| 261QP1100X Clinic/Center Podiatric | |
| Enumeration Date | 2017-12-28 |
| Last Update Date | 2022-01-07 |