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
6310 SAN VICENTE BLVD STE 220, LOS ANGELES, CA 90048-5458
(323) 937-6903
(323) 210-7171
Mailing address
6310 SAN VICENTE BLVD STE 220, LOS ANGELES, CA 90048-5458
(323) 937-6903
(323) 210-7171
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
E4429
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000E28430
—
CA
Enumeration date
12/27/2007
Last updated
09/02/2021
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