| NPI | 1942714498 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA BANKS Podiatrist 562-505-5978 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: CA e4808) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CA e4808) |
| Enumeration Date | 2017-11-20 |
| Last Update Date | 2018-03-17 |