| NPI | 1780873778 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMERA CHRISTINE MARILUCH Office Manager 714-991-3333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery |
| Enumeration Date | 2007-10-16 |
| Last Update Date | 2024-01-10 |