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Organization
SOUTHERN CALIFORNIA PODIATRY GROUP, INC.
Active
Organization
SOUTHERN CALIFORNIA PODIATRY GROUP, INC.
Active
Other names
DSP
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JASON WACH (TREASURER/SECRETARY)
(562) 896-5899
Entity
Organization
Contact information
Practice address
2661 E FLORENCE AVE, SUITE B, HUNTINGTON PARK, CA 90255-4793
(323) 583-4440
(323) 583-4499
Mailing address
6030 VALENCIA ST, CORONA, CA 92880-3088
(562) 896-5899
(562) 236-1283
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
Other
Enumeration date
10/09/2006
Last updated
08/22/2020
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