| NPI | 1962722983 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAY MUKKER Owner 559-224-5101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CA E4656) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: CA e46560) |
| 335E00000X Prosthetic/Orthotic Supplier (Licence: CA e46560) | |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: CA e46560) | |
| Enumeration Date | 2010-06-02 |
| Last Update Date | 2012-06-06 |