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AMBULATORY FOOT CARE PODIATRY CLINIC INC. NPI 1831384163


NPI Information

NPI: 1831384163
Provider Name: AMBULATORY FOOT CARE PODIATRY CLINIC, INC.
Classification: Podiatrist - 213ES0103X
Entity Type: Organization

Specialization: Foot & Ankle Surgery

Address:
12902 BROOKHURST ST
SUITE B
GARDEN GROVE, CA
ZIP 92840
Phone: (714) 636-3211
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AMBULATORY FOOT CARE PODIATRY CLINIC, INC. is a foot and ankle surgery podiatrist in Garden Grove, CA. AMBULATORY FOOT CARE PODIATRY CLINIC, INC. NPI is 1831384163. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

12902 BROOKHURST ST
SUITE B
GARDEN GROVE, CA
ZIP 92840-881
Phone: (714) 636-3211
Fax: (714) 636-5956

The provider's authorized official is Thu Kim Van .
The authorized official title is Ceo and has the following contact phone number (714) 636-3211.

The enumeration date for this NPI number is 9/10/2007 and was last updated on 12/26/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1213ES0103XPodiatristFoot & Ankle SurgeryE3686CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1GRE000290MEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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