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Organization
MED-PED I D INCORPORATED
Active
Organization
MED-PED I D INCORPORATED
Active
Other names
Total Foot & Ankle Restoration & Preservation
Organization subpart
No
Provider details
NPI number
Authorized official
SONG YUN RN (NURSE MANAGER)
(951) 679-5811
Entity
Organization
Contact information
Practice address
28078 BAXTER RD STE 424, MURRIETA, CA 92563-1404
(951) 679-1020
(951) 679-5844
Mailing address
28078 BAXTER RD STE 424, MURRIETA, CA 92563-1404
(951) 679-1020
(951) 679-5844
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1548271828
NPI
CA
01
—
1578946182
NPI
CA
01
—
1851805204
NPI
CA
Enumeration date
07/02/2019
Last updated
07/02/2019
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