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Organization
ACCESS WOUND CARE AND PODIATRY CARE CLINIC
Active
Organization
ACCESS WOUND CARE AND PODIATRY CARE CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES BLAINE DPM (DPM)
(800) 480-3338
Entity
Organization
Contact information
Practice address
1510 S CENTRAL AVE, SUITE 120, GLENDALE, CA 91204-2500
(800) 480-3338
(818) 790-3121
Mailing address
1510 S. CENTRAL AVE, SUITE 120, GLENDALE, CA 91204
(800) 480-3338
(818) 790-3121
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
E3817
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000E38170
—
CA
Enumeration date
03/13/2009
Last updated
03/13/2009
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