FOOT AND ANKLE WELLNESS CLINIC NPI 1235313123

NPI Information

NPI: 1235313123
Provider Name: FOOT AND ANKLE WELLNESS CLINIC
Classification: Podiatrist - 213ES0131X
Entity Type: Organization

Specialization: Foot Surgery

Address:
6310 SAN VICENTE BLVD STE 220
LOS ANGELES, CA
ZIP 90048
Phone: (323) 937-6903
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FOOT AND ANKLE WELLNESS CLINIC is a foot surgery podiatrist in Los Angeles, CA. FOOT AND ANKLE WELLNESS CLINIC NPI is 1235313123. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

6310 SAN VICENTE BLVD STE 220
LOS ANGELES, CA
ZIP 90048-458
Phone: (323) 937-6903
Fax: (323) 210-7171

The provider's authorized official is Suzanne Lee Mancherian .
The authorized official title is President and has the following contact phone number (323) 937-6903.

The enumeration date for this NPI number is 12/27/2007 and was last updated on 9/2/2021.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	213ES0131X	Podiatrist	Foot Surgery	E4429	CALIFORNIA	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	000E28430	MEDICAID	CALIFORNIA

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: 11/14/2023

NPI Synchronization or Removal

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