| NPI | 1821749615 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH G MELENDEZ Practice Manager 760-889-1941 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213EP1101X Podiatrist Primary Podiatric Medicine |
| Enumeration Date | 2022-01-12 |
| Last Update Date | 2022-01-12 |