| |
24865 Del Prado, Dana Point, CA 92629-2853 | |
(949) 248-4822 | |
(714) 841-9595 |
Full Name | |
---|---|
Type | Facility |
Speciality | Podiatrist - Foot & Ankle Surgery |
Location | 24865 Del Prado, Dana Point, California |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1114140191 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
213ES0103X | Podiatrist - Foot & Ankle Surgery | E2231 (California) | Primary |
Mailing Address | Practice Location Address |
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24865 Del Prado, Dana Point, CA 92629-2853 Ph: (949) 248-4822 | 24865 Del Prado, Dana Point, CA 92629-2853 Ph: (949) 248-4822 |