Organization
FOOT AND ANKLE WELLNESS CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUZANNE LEE MANCHERIAN DPM (PRESIDENT)
(323) 937-6903
Entity
Organization
Contact information
Practice address
1030 S GLENDALE AVE, SUITE 504, GLENDALE, CA 91205
(818) 240-7673
(323) 937-2035
Mailing address
6200 WILSHIRE BLVD STE 1712, LOS ANGELES, CA 90048-5818
(323) 937-6903
(323) 210-7171
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
E4429
CA
Other
Enumeration date
05/22/2008
Last updated
06/06/2018
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