| NPI | 1891809554 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE MARIE GORDON-BARRETTO Office Manager 661-290-2857 |
| Organization Subpart ? | |
| Primary Taxonomy | 213ES0131X Podiatrist Foot Surgery (Licence: CA E2604) |
| Additional Taxonomies | 213ES0131X Podiatrist Foot Surgery (Licence: CA E2819) |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2015-05-18 |