Individual
DR. MICHAEL BLAKE RUNYON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
13701 BURBANK BLVD, VAN NUYS, CA 91401-5040
(818) 997-1216
(818) 997-4458
Mailing address
13701 BURBANK BLVD, VAN NUYS, CA 91401-5040
(818) 997-1216
(818) 997-4458
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
E1908
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
E1908
CALIFORNIA STATE LICENSE
CA
Enumeration date
03/09/2006
Last updated
03/07/2023
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