# FOOT & ANKLE CHAMPIONS INCD

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730623620
- **Authorized official:** DR. MICHAEL CORPUZ DPM (PODIATRIST)
- **Authorized official phone:** (310) 475-5377

## Contact information

- **Practice address:** 2288 WESTWOOD BLVD, 100, LOS ANGELES, CA 90064
- **Practice address phone:** (310) 475-5377
- **Practice address fax:** (310) 446-1825
- **Mailing address:** 4115 CENTRALIA ST, LAKEWOOD, CA 90712
- **Mailing address phone:** (562) 857-7823
- **Mailing address fax:** (310) 446-1825

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | NULL | Yes |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | — | Yes |

## Other

- **Enumeration date:** 12/12/2016
- **Last updated:** 12/12/2016